Premier’s HCC Coding Solutions for Payers
Accurate Hierarchical Condition Category (HCC) coding is essential for payers to ensure appropriate reimbursement and effective risk adjustment. However, traditional processes can be inefficient, costly and prone to errors.
Premier’s Stanson Health CodingGuide offers an artificial intelligence (AI)-powered solution designed for payers, streamlining HCC coding within electronic health records (EHRs) to improve accuracy, reduce administrative challenges and foster stronger payer-provider collaboration.
Smarter HCC Coding, Stronger Financial Performance
The complexity of HCC coding can lead to inaccurate risk scores and missed reimbursement opportunities. CodingGuide leverages advanced natural language processing (NLP) to:
- Embed HCC coding automation into provider workflows, ensuring real-time, evidence-based coding at the point of care.
- Reduce the administrative burden for both payers and providers, minimizing the need for retrospective audits and coder intervention.
- Improve documentation and reimbursement accuracy, helping payers confidently manage risk and compliance.
CodingGuide ensures payers have the reliable tools needed to support accurate risk adjustment while maintaining trust with providers and patients.
Stronger Payer-Provider Collaboration for Medicare Advantage
With a growing number of Medicare beneficiaries enrolled in Medicare Advantage and billions in federal spending at stake, accurate HCC coding is critical to ensuring adequate payment for patient risk. CodingGuide empowers payers to:
- Engage providers in real-time coding at the point of care, reducing the burden of retrospective reviews and ensuring diagnoses are accurately captured when they matter most.
- Support accurate risk adjustment factor (RAF) scores, leading to appropriate reimbursement and improved financial stability.
- Enable real-time revalidation of HCC codes, helping to ensure the right codes are assigned for patient’s current health status.
- Gain actionable insights through monthly analytics reports, verifying the impact of automated coding at the claim level.
Why Payers Choose CodingGuide
Seamless EHR Integration
Automates HCC alerts within provider workflows, reducing errors and improving coding accuracy.
Reduced Administrative Burden
Minimizes the need for manual coding interventions and retrospective audits.
More Accurate Risk Adjustment
Ensures payments reflect the true clinical risk of each patient, preventing financial discrepancies.
Data-Driven Decision-Making
Monthly analytics reports provide payers with key insights into HCC coding improvements and compliance.
Get Started Today
Discover how CodingGuide can help payers enhance HCC coding, strengthen provider collaboration and drive more accurate risk adjustment.