Full Service Coding Solutions

Coding Services

Ensure accurate, compliant, and financially optimized coding by leveraging RiskCode’s industry-leading technology and highly trained medical coders and billers. Whether you’re looking for temporary or long-term assistance, you can rely on RiskCode to support your operations, improve quality, and experience a meaningful return on investment.
Experience cost savings, quick turnaround, and flexible staffing solutions with offshore and onshore options. Our certified experts, extensively trained with a minimum of 5 years of experience, cover over 80 medical specialties, delivering top-tier results tailored to benefit your healthcare organization.

Professional Coding

Embark on a journey of healthcare excellence with our professional fee coding services. Our team of expert coders navigates the complexities of professional fee coding with unwavering attention to detail. Let us be your trusted partner in ensuring compliance, efficiency, and financial optimization.
Office Visits
Home Visits
Surgery
Emergency Department
Urgent Care
Radiology
HCC

Facility Coding

Elevate your facility’s performance with our cutting-edge facility coding services. As a beacon of precision, we unravel the intricacies of medical data, delivering exceptional results. Our expert coders, with unmatched attention to detail, ensure utmost accuracy to drive operational excellence and ensure your facility performs at its peak.
Ambulatory Surgery
Ancillary Services
Rehabilitation (PT/OT/ST/Cardiac)
Labs
X-rays, CTs, MRIs, PET scans, etc.
Nuclear Medicine
Emergency Department (ER)
Urgent Care (UC)
HODs (Hospital Outpatient Departments)
Home Health

Revenue Cycle Management For All Medical Specialties

Work with experts in your specialty

We service all medical specialties

Cardiology

Neurology

Orthopedic

Gastroenterology

Maternity

Pathology

CALL US NOW :

(833) 510-4332

Risk Adjustment Coding

Maximize your risk adjustment accuracy and achieve your revenue goals with our certified auditors and coders. Our team delivers precision coding, reducing claim denials and boosting revenue with a 98% accuracy rate across 10K+ medical records audited annually. Stay compliant with CMS guidelines, streamline operations through seamless integration, and receive ongoing support and training for an efficient and hassle-free coding process.
High-accuracy Diagnostic Coding
HCC completeness and accuracy review
Verify risk-adjusted codes and documentation
With the transition to value-based care models through Accountable Care Organization partnerships, it’s important for physicians and healthcare organizations to understand the impact on patient care and reimbursement. Risk adjustment coding reviews are an essential component of financial success in these valued-based contracts.
Best practices and actionable strategies in performing both pre- and post-risk coding reviews, overcoming implementation challenges, and harnessing the benefits of technology.
Maximize your risk adjustment accuracy and meet your revenue goals when you rely on our certified auditors and coders to identify gaps in care, assessment, and clinical documentation. With a 98% accuracy rate across the 10K+ medical records we audit every year, we find undocumented chronic conditions in nearly 95% of the charts we review.
We’re committed to ensuring you receive equitable compensation for the health conditions, health status, and demographics of your beneficiaries.

Prospective Risk Adjustment Chart Review

Our certified auditors and medical coders will identify gaps in care, assessment, and clinical documentation. And we equip your physicians for optimal patient monitoring and point-of care decisions, informed of chronic conditions, and suspected HCCs.

Retrospective Risk Adjustment Chart Review

Raise your risk-adjusted revenue and reduce your CMS RADV audit risk with our flexible services, ranging from focused audits for target populations and specific HCCs to end-of-year sweeps. Our experienced teams review patient encounter data in clinical documentation to identify diagnoses and conditions missing from original claims.

Concurrent Risk Adjustment Chart Review

Trim the intensity, cost, and error potential of annual sweeps by ensuring HCCs are captured correctly on encounter claims. Our RA team reviews for under-documented risk opportunities and verifies that all codes and conditions are accurate and supported by proper documentation. Missed diagnosis codes are then updated within the workflow, prior to claim submission.

Mock-Run RADV Audit Services

Mitigate your Risk Adjustment Data Validation (RADV) audit risks when our risk adjustment teams outline your substantiated HCCs, unsubstantiated HCCs, and unreported HCCs and equip you with actionable items to secure your compliance and safeguard your risk-adjusted revenue.

Initial Validation Audit (IVA) Services

Our IVA teams have the data validation expertise to lead you through the IVA process. We’ll complete your risk adjustment IVA on time and in compliance with HHS’s requirements for validation of member demographic and enrollment data, medical claims data, and health status data.

Provider Engagement & Risk Adjustment Education

Our Provider Engagement and Risk Adjustment Education programs bridge the gap between your health plan and your providers. While nurturing engagement and partnership, we make sure your providers have the training and support needed to implement RA best practices. And we help establish processes to tract suspects, follow through with patient outreach, and optimize documentation and coding.

HCC Coding

Your health plan can rely on us to capture severity levels and secondary manifestations as we have extensive experience extracting diagnoses that substantiate disease and comorbid condition data. You can also count on us to perform quality assurance of all coding results to ensure your submission to CMS is accurate, optimal, and compliant.

Advantages of Our Risk Adjustment Solutions

We offer a full catalog of risk adjustment solutions, customized to meet the needs of small physician practices, a mid-size health plans, and multi-hospital health systems. Our teams specialize in risk methodologies, such as:
CMS-HCC Model
DxCG Model
Medicare and Medicaid CDPS Model
HHS HCC Model
ACO Model
ESDR Model
PACE Model
Hybrid Risk Models

FAST SOLUTION

3 Easy Simple Steps And Get Your Solution

Efficient and Accurate Practice Management Solutions for Better Health

Step 1

Call us or submit a form. An expert practice consultant is waiting to serve you.

Step 2

Review proposal in one phone call. Analyze your practice’s needs and review services that may increase profitability.

Step 3

Finalize your contract. We can start serving you in as little as 5 days.

RiskCode Consulting LLC