Medical Reimbursement Specialist


Medicare Risk Adjustment Data or Hierarchical Condition Categories (HCC)

Moving from v24 to v28 on January 1, 2024!

Call our office today to prepare for the transition. If you have a high percentage of Medicare Advantage patients, being prepared for this transition is crucial to your continued healthy bottom line.

Request a copy of 2024 deleted and NEW codes!
** The HCC handout is also available with RAF to analyze its impact on your bottom line. Please call the office to request: 562-430-6847 or email vimenchaca@reimbursementspecialist.com.

What is a CMS-HCC Chart Review?

Some chart reviews are done to ensure that deserved reimbursement reaches your practice. The HCC Chart Review is one example.

Through a CMS-HCC chart review, the reviewer gleans out of your documentation those codes that may have been missed by the provider; or that may have been omitted from the encounter data submission; or that you may have been unaware merited a separate condition code. Submitting these by the deadline date guarantees that your payments will reflect deserved reimbursement.

As part of the process, you will receive tips on how to improve your documentation to support the diagnosis code assignment.

Your 2024 payments for patients in a Medicare Managed Care plan are based on the diagnoses submitted for those patients in 2023. 2024 payments are a blended rate of 67% v24 RAF plus 33% v28 RAF.

Our staff of certified coders are experienced in abstracting charts for this vital information. We have extensive experience in providing bilingual (Enlish/Spanish) guidance in this area.

How does CMS-HCC work?

What you can do today -


** The HCC handout is also available with RAF or Category. Please call the office to request: 562-430-6847.




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Reimbursement Specialist
Tel: 562-430-6847
Fax: 562-430-6849


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