HCC

HCC Highlights

• Used to report Hierarchical Condition Categories for Medicare Managed Care Plans

• Physicians receive higher capitation rates when they include HCC codes

• Allscripts contracts with 3M Health Information Systems to obtain HCC diagnosis data. The data is passed through the Delta process.

• Patient's Insurance must be a Medicare managed care plan

• HCC will appear red until has been assessed during the calendar year, once assessed it will appear with a green check mark, after that calendar year (January 1) it will turn red again

• HCC Indicator will appear within the patient's active problem list and will display whether or not the problem has been assessed or not (for the calendar year) and will display the date last assessed

HCC Set Up

Based on an enterprise-level preference, the system displays an indicator for HCC-related diagnoses when the patient’s insurance for the encounter is linked to Medicare Managed Care.

The system displays the HCC icon under the following conditions:

• The Medicare HCC Diagnosis Checking preference is turned on.

• The patient’s insurance is flagged as Medicare Managed Care.

Detailed Information

• The system displays the last submitted date for diagnoses on the patient past diagnosis list.

• The HCC will appear red until it has been assessed during the calendar year. Once it has been assessed it will appear with a green check. After that calendar year it will return to red.

HCC Indicators appear in the following Charge-related workspaces in TouchWorks:

• Diagnosis Selector

• Visit Charge Selector

• Procedure Charge Selector

• Encounter Form

• Charge Details page

HCC Indicators on the Diagnosis Selector workspace

HCC Indicators appear in the following Problem-related workspaces in Enterprise EHR:

• Indicator will display as either assessed or not assessed (for the calendar year) within the

patient's Active Problem list

• Problem search view

• When the system displays an HCC indicator, it displays both the HCC icon and the date on which the diagnosis was last submitted to the patient past diagnosis list.

• There are no documented changes in functionality or display of HCC codes from version 11.1.7 to 11.2

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