Medicare Risk Adjustment for the Health Insurance Industry
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Medicare Risk Adjustment

By using Verscend to retrieve and code patient medical records, Medicare Advantage plans can ensure appropriate, efficient, and cost-effective CMS reimbursement.

Verscend specializes in the retrieval, digitization, and indexing of patient medical charts as well as the relevant ICD-9 CM and HCC coding aspects of the Medicare Risk Adjustment process. In particular, Verscend can help you with the following:

Online Medical Record Retrieval

Verscend’s RapidRetrieve™ system can scale to any volume of requests while maintaining fast turnaround times.

Coding

Our experienced team of coders can be utilized as a complete coding solution or as a supplement to your current process or team.

Experienced Professional Coders

Verscend has AAPC certified and experienced medical coders.

ICD-9 Coding

Verscend can abstract all ICD-9 codes in the patient chart based upon the documentation provided. This can include only ICD-9 codes which have a corresponding HCC or all ICD-9 codes found in the medical record.

HCC Coding

Verscend can abstract all HCC codes to assist Medicare Advantage plans in completing accurate risk assessment of their membership and submit complete and accurate data for a RAPS file before CMS deadlines.

Errors & Omissions Coding

Verscend coders are skilled in identifying document issues in medical records that may not pass a CMS audit. For example, coders can identify issues such as: no physician signature on the record, missing provider credentials, unacceptable provider type, missing patient name on the record, missing date of birth on the record, illegible record, etc.

Provider Education Materials

As an invaluable resource to both health plans and the providers included in the MRA chart review, provider education materials are a tool to help providers identify areas for improvement in their record documentation and also provide general coding guidelines. Verscend has standard provider education materials but can also develop additional customized materials. (Sample report.)

Record Documentation Management and Workflow

Verscend uses RapidReview, an online workflow system to review, annotate and identify HCC codes within medical records. Because all records are digital, the coders can access the records over the Internet any time, anywhere.

RADV Audits

Verscend understands the importance of retrieving large volumes of medical records in a short time to meet CMS deadlines for RADV audits. RapidRetrieve creates specific retrieval and follow-up parameters to insure that all requested records are retrieved and delivered to meet these deadlines.

Medicare Risk Adjustment Services

  • Online Medical Record Retrieval
  • Coding
  • Experienced Professional Coders
  • ICD-9 Coding
  • HCC Coding
  • Errors & Omissions Coding
  • Provider Education Materials
  • Record Documentation Management and Workflow
  • RADV Audits