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BC Advantage - 2024 Issue 3

Everything You Need to Know About the CMS-HCC-V28 Changes and How AI Helps

A new year brings excitement, fresh starts, and the latest changes to the CMS-HCC (Centers for Medicare and Medicaid Services hierarchical condition category) risk adjustment model, version 28 (V28). And even if you're excited about 2024, the guideline updates are probably stressful and a bit deflating. It can take months for coding and revenue cycle teams to get up to speed with the latest updates, and the training and accompanying expenses – as well as the inevitable mistakes that come with any coding update – cause billing delays, underpayments, and claim denials. Most healthcare organizations likely still have last...

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