HCC Coder/Auditor Course 

This highly specialized online course is brought to you through a collaboration between AHIMA and MARSI.
AHIMA is the premier association of health information management (HIM) professionals worldwide and is a respected authority for rigorous professional education and training.
 
MARSI is an industry leader in risk adjustment documentation, coding, & auditing.
The prerequisites for this course are anatomy, physiology, and medical terminology and a working knowledge of ICD-10-CM.

 

Coder Auditor Course - Overview

The Risk Score

Higher risk scores represent members with a greater than average burden of illness.
Lower risk scores represent a healthier population, but may also falsely indicate a healthier population due to:
 
1.  Inadequate or incomplete chart documentation.
2.  Incomplete or inaccurate diagnosis coding.

What is Risk Adjusted Reimbursement?

Risk adjustment is a process of collecting all diagnosis codes from patient charts and using these illnesses (along with their comorbidities and complications) to determine the ICD-10 codes which drive risk . . . risk for the patient & risk of increased cost to take care of the patient. 

 

The Purpose of Risk Adjustment

Promotes higher quality care through the focus on the identification and treatment of all of the patient's risk conditions.  Ensures accurate and adequate payment based on expected medical costs.  Incorporates each member's health status reflecting costs associated with their health care needs.