R1 HCC Capture is powered by advanced technology and audit expertise to identify and validate high-volume claims that have hidden reimbursement potential. With R1 HCC Capture, providers can confidently navigate the complex coding landscape by ensuring that the appropriate hierarchical condition category (HCC) is captured on every encounter.
HCC Capture by the numbers
20
average Medicare Advantage claims miscoded
$250K
approximate RAF value found per month
Day 1
positive impact to RAF scores after implementation
Target complete documentation with a compliance-first approach
R1 HCC Capture uses analytics and proprietary rules to efficiently review and identify HCC coding gaps, driving earned reimbursement and complying with regulatory guidelines. Our non-disruptive approach is designed to relieve the documentation burden on clinicians and staff, with skilled coders who review every HCC opportunity.
Improve HCC coding with tech-driven expertise
R1 HCC Capture seamlessly integrates advanced technologies with expert coding services to review high volumes of ambulatory encounters and identify opportunities for adding or deleting HCC’s. As Medicare Advantage plans grow, we help keep you contract compliant and ensure your expected costs are correctly captured.
Ensure your Risk Adjustment Factors (RAF) reflect true case complexity
Our solution automatically finds encounters that have been incorrectly or insufficiently coded and routes the records for review by our coding and billing experts. This ensures full documentation accuracy to help capture and elevate Risk Adjustment Factor (RAF) scores, improving revenue and ensuring high quality care for Medicare Advantage patients.
Get pricing that reflects value
With our safety-net, pay-for-value model, you only pay when an HCC code is added, modified or deleted—helping to ensure maximum return on investment.
Reduce the burden on clinicians
Providers are experts at patient care, not coding, leading to gaps between the clinical documentation and HCC coding. Our coding experts leverage advanced technologies to identify and correct documentation gaps and coding inconsistencies that impact revenue and the patient experience.
A simple solution to cut through HCC complexity
Overcome HCC challenges with an intelligent coding engine identifying coding gaps and routing claims to coding experts for reconciliation and resolution.
