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Risk Adjustment Coding Services

At CodeEMR, our certified coders provide specialized Risk Adjustment Coding Services and ensure precise HCC scoring to help healthcare providers and payers succeed in value-based care models.

Drive Accurate Reimbursements and Mitigate Risk with CodeEMR’s Expertise

At CodeEMR, we understand the critical role risk adjustment coding plays in today’s value-based care environment. Accurate HCC coding not only ensures appropriate reimbursements but also paints a true picture of patient complexity – directly impacting quality scores and compliance.

Our risk adjustment coding services are designed to help payers, physician groups, MSOs, ACOs, and healthcare organizations accurately capture patient risk profiles while reducing audit exposure.

Why Choose CodeEMR for Risk Adjustment Coding?

Certified, Specialized Coders

Our team comprises AAPC and AHIMA-certified coders with deep expertise in HCC coding (Medicare Advantage, ACA, Medicaid, RADV), HCC, ICD-10, and risk models.

End-to-End Coding Workflow

From chart retrieval and clinical documentation review to coding and submission, we offer seamless processes that boost RAF scores while maintaining strict compliance.

Stringent Quality Audits

Every chart goes through multi-level QA, ensuring complete and accurate capture of all relevant conditions. This reduces downstream risk and protects against penalties.

Compliance & Audit Readiness

Ensure CMS, Medicare Advantage, and ACA compliance to minimize risk.

Comprehensive Chart Reviews

In-depth retrospective and prospective coding audits for accurate documentation.

Payer & Provider Solutions

We support health plans, ACOs, and provider groups in maximizing reimbursements.

Flexible Engagement Models

Choose from full-service coding, concurrent reviews, or retrospective audits - tailored to your workflows and EMR systems.

What We Code

✅ Hierarchical Condition Categories (HCC) Coding
✅ Chronic Disease Coding and Validation
✅ Medicare Advantage (MA) and ACA Plan Coding
✅ Chart Audits & Risk Score Optimization

Our Risk Adjustment Coding Process

Secure Data Intake

We securely retrieve medical records via direct EMR access, SFTP, or your preferred method.

Thorough Review & Coding

Certified coders review documentation, abstract diagnoses, and apply appropriate HCC codes.

Robust QA & Compliance Checks

Each coded chart undergoes multiple rounds of audits to ensure completeness, accuracy, and compliance with CMS guidelines.

Detailed Reporting & Feedback

We deliver coding outcomes, risk scores, and gap analyses to your team, enabling targeted clinical interventions.

Interested in learning more?

Benefits of Partnering with CodeEMR

✅ Improve RAF Scores & Optimize Reimbursements
✅ Mitigate Risk of RADV & OIG Audits
✅ Gain Deeper Visibility into Population Health

Trusted by Payers, MSOs & Provider Groups Nationwide

We help healthcare organizations across the U.S. achieve accurate risk adjustment coding – improving revenue integrity and compliance. Whether you need ongoing HCC coding support or retrospective reviews, CodeEMR acts as an extension of your team.