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 icon will appear in the following charge-related workspaces:

1. Diagnosis Selector

2. Visit Charge Selector

3. Procedure Charge Selector

4. Encounter Form Summary

5. Charge Deatils Page

• There are no documented changes in functionality or display of HCC codes from version 11.1.6 to 11.1.7

Set Up:

HCC is an additional function that requires a per provider cost.

Enterprise-Level Charge Preferences - Hierarchical Condition Category (HCC) Checking Turned On

Insurance Class needs to be set to "Medicare Managed Care"

Contact Allscripts to purchase HCC module and have this function enabled