High-Volume Medicare HCC Coding for a Texas-Based Healthcare Services Firm
High-Volume Medicare HCC Coding for a Texas-Based Healthcare Services Firm
Client: A leading healthcare services company headquartered in
Austin, Texas-USA.
Partner: Addnectar—Specialists in Risk Adjustment Coding (CMS-HCC,
HHS-HCC, Medicaid CDPS), RCM services, and full-spectrum healthcare
outsourcing.
In March 2023, the client approached Addnectar with an urgent requirement for
Medicare Risk Adjustment Coding. They had 42,000 charts awaiting coding and
audit and needed them completed within 7 weeks—without delays and with a
strong focus on quality and compliance.
The Challenge-
Our coding team faced a few critical challenges during the engagement
- Immediate Turnaround: The client wanted the project to start right away, expecting a quick ramp-up and results from day one.
- Unfamiliar Software Platform: The coding was to be done using a proprietary software platform, which our team had never used before and needed to master quickly.
Project Proposal-
To tackle the project successfully, Addnectar laid out a focused plan:
We are dedicated to protecting ePHI against unauthorized access, alteration, loss, or disclosure. Our data protection measures include:
- Staffed Experienced Medicare HCC Coders A team of certified coders, each with at least 2.5 years of experience in Medicare HCC coding, was onboarded.
- Created a Dedicated Project Team: A focused group of coders, team leads, and QA auditors was formed exclusively for this client.
Training & Assessments:
- Team members received software navigation and project-specific training.
- Coders were tested post-training to validate understanding.
- An internal calibration session was conducted using 15 sample
charts before live production.
Real-Time Feedback & Tracking Tools
- Shared quality, feedback, and progress trackers were developed.
- All project documents were stored in a centralized shared drive, accessible to every team member.
The Solution
Addnectar executed the project with precision and a client-first approach:
- Pilot Calibration Phase
QA and training leads coded 15 test charts and submitted them for client
feedback. Adjustments were made based on comments, and process
Documentation was updated for the wider team. - Efficient Resource Allocation
A dedicated and certified HCC team was deployed, with QA support
embedded throughout the production cycle. - Transparent Communication
Daily progress reports were shared with the client, along with weekly
summary calls to ensure alignment and quick resolution of any blockers. - On-Time, High-Quality Delivery
The team successfully completed coding and auditing for all 42,000
charts within the agreed 7-week timeline, maintaining a quality accuracy
score of 98.7%.
Results
Metric Outcome
Total Charts 42,000 CMS- HCC
Completion Time 7 Weeks
Accuracy Rate 98.7%
Client Satisfaction Excellent
The client was highly satisfied, praising the team’s responsiveness, quality control, and structured execution. The engagement has since expanded to include ongoing monthly risk adjustment coding assignments.
Conclusion
This project highlighted Addnectar’s ability to scale quickly, adopt new technologies, and deliver on large-scale Medicare HCC coding projects with efficiency and precision. The success story solidified Addnectar’s role as a go-to partner for high-volume risk adjustment solutions.