Hierarchical Condition Categories

The reimbursement model for Medicare Advantage is an excellent system. It parallels and supports what physicians do:

•  Identify disease states early, treat them appropriately and get reimbursed for doing so.

•  It is a Risk Adjusted system that promotes Quality Care.

•  If done right, RA/HCC provides generous revenue for the quality care of patients and should still save CMS and taxpayers money.

Physicians Drive Reimbursement

The problem with this relatively new system is just that — it is new.  Physicians drive the reimbursement through their documentation, but most don't understand how it works.

Basically, physician documentation has never emphasized ICD-9 coding, but RA/HCC requires that, specifically.

Expert Focus & Experience

A leader for almost 2 decades, MARSI has proven systems and procedures for physician documentation improvement with DRGs and RA/HCCs that work. 

MARSI usually finds large amounts of lost revenue while reconciling overcoding and under documentation.