From Inefficient, Error-Prone, and Stressful to Smooth and Streamlined
Arizona Community Physicians (ACP) is a leader in value-based care. Their Accountable Care Organization (ACO), Abacus Health, was selected to participate in the Medicare Shared Savings Program (MSSP) beginning on January 1, 2016.
Initially, ACP employed three full-time coders to manually review all medical records and associated claims for 12 of their 53 locations. These three ACO employees were stretched thin, constantly rushing to get claims out to payers. Errors were common, and time-consuming to correct. ACP needed a better solution that would be scalable to include all 53 locations.
The organization turned to RCxRules to reduce time spent on HCC coding review, minimize costs, and streamline operations while maintaining or improving HCC accuracy.
How HCC Coding Software Changed the Game
By leveraging the RCxRules software to automate their pre-claim coding review process, ACP significantly reduced the time and resources required to perform their comprehensive HCC review process, while improving accuracy.
Increased Coder Productivity
The new and improved process only requires two HCC coders to cover all 53 locations. Rather than three stressed out employees covering just 12 sites, ACP has two coders who can comfortably complete the work needed for 53 sites without time-consuming errors.
Improved RAF Accuracy
RCxRules eliminated the need for a manual, retrospective HCC coding review process. Now the software automatically reviews every encounter that is finalized in the EMR and identifies encounters that may warrant a more accurate and specific diagnosis code.
"The automation RCxRules brought to our HCC coding process led to a dramatic productivity hike in our organization and is a key factor in our success with MSSP,” says Kimberly Clifton, Director of ACO Operations.
Find out how other large medical groups use RCxRules HCC Coding software to improve HCC coding accuracy by exploring these success stories.
