Using the Most Recent Technology and Valuable Insights, MEAT Criteria Reduces Audit Risk

 

How frequently do you check and verify the HCC Coding's accuracy?

We have previously written on the significance of correct risk adjustment documentation and HCC coding. We will give you useful advice on how to use M.E.A.T. criterion audits to advance your HCC coding and risk adjustment in today's article.

You are aware of the significance of HCC Coding as a provider. To reduce your risk of lesser payments, audits, and financial penalties, you probably spend a lot of effort ensuring sure you include the correct HCC codes in your documents and remaining current with adequate supporting evidence for HCC codes.

Healthcare organizations employ M.E.A.T. criteria guidelines to accurately document and streamline this process. Following the M.E.A.T. criteria requirements guarantees that revenue cycle firms, practice management consultants, coding companies, and healthcare provider organizations routinely monitor and audit for accurate HCC coding.

What does M.E.A.T. actually stand for? Here is a quick reminder:

You can succeed in RADV audits (Mandatory CMS and Health and Human Services Audits are Called Risk Adjustment Data Validation) by checking off all the M.E.A.T. criteria. In these audits, CMS stipulates that diagnosis codes (ICD-10) supplied must adhere to the Official Coding Guidelines and must be completely supported by documentation from the medical record. It is crucial that diagnosis codes reported on a claim are supported by medical record documentation. Additionally, thorough documentation will make it easier for providers to meet the criteria for other alternative payment models including Stars, HEDIS, MIPS, and MACRA.

The provider must completely and accurately describe in a patient's medical record all chronic illness processes and manifestations that are both active and/or have a relevant history in order to assign HCC codes to a claim.

The best way to guarantee accurate HCC code is to apply MEAT culture to HCC reasoning and make sure it is documented.

HCC Coding and meeting MEAT Criteria's additional requirements

Coding leaders should discuss these issue areas with risk adjustment coding specialists, as stated by Ahima International. Leaders not only make sure possibilities for more HCCs are taken advantage of, but they also make sure opportunities to fix incorrectly reported HCCs are found. To guarantee general coding conformity, the balance is necessary. In order to avoid inadvertently recording an HCC that could result in an exaggerated RAF, the coding leadership would frequently take advantage of an opportunity connected to malignancies by making sure that documentation clearly supported active or historical status.

HCC Validator technology for meat criterion

Inferscience provides an HCC Validator solution to enhance the auditing of documents against MEAT standards. The HCC Validator employs cutting-edge NLP technology to immediately evaluate HCC codes against MEAT criteria and offers a clear "Pass" or "Fail" grade for your provided HCC Codes. (Learn more about HCC Assistant.) You can be more certain that patients' HCC diagnoses are accurately and completely documented thanks to the HCC Validator®, which removes the element of the guesswork from risk adjustment paperwork.

The HCC Validator:

Features

• Intelligent technology that analyzes and audits diagnosis codes
• Pass or fail indication of each HCC Code documented.
• The system provides information about what needs to be reviewed and corrected in order to meet the correct criteria.
• Data sources and rule logic to define audit are provided.

Benefits

• Time savings You no longer have to spend countless hours analyzing retrieved patient charts to identify source encounter notes for reported diagnosis codes, the system does it for you.
• Accuracy in your documentation by auditing whether encounter notes have the required elements to support HCC codes based on your guidelines
• Helps you confirm the integrity of your HCC submissions
• Coding specificity Provides enough information to back up your codes with more specific information.
• Helps you ensure that the health status submitted by the plan is supported by health record documentation and meets reporting guidelines
• Helps you ensure their documentation complies with HCC reporting requirements and demonstrates that conditions are evaluated, monitored, assessed, and/or treated during face-to-face encounters.

To get more information about the HCC Validator visit our website now.