HCC and Risk Adjustment: Maximizing Accuracy and Compliance

Course Description

Health care organizations continue to face increasing scrutiny around documentation, coding accuracy, and compliance within the Hierarchical Condition Category (HCC) risk adjustment model. As CMS intensifies oversight and Medicare Advantage plans face deeper audits, the need for precise risk adjustment coding has never been more critical. HCC and Risk Adjustment: Maximizing Accuracy and Compliance is designed to help coding professionals, auditors, providers, and compliance leaders strengthen their understanding of the risk adjustment process and improve the integrity of their documentation practices.

During this webinar, participants will explore the essential components of the CMS-HCC model, including how chronic conditions, documentation specificity, and the MEAT (Monitor, Evaluate, Assess/Address, Treat) criteria directly impact risk scores. We will discuss common pitfalls that lead to coding inaccuracies and audit vulnerabilities, along with practical strategies to enhance provider education and support compliant workflows.

Attendees will also gain insight into emerging trends in risk adjustment, including CMS regulatory updates, RADV audit implications, and best practices for ensuring high-quality documentation across care settings. Whether you are new to HCC coding or looking to refine advanced skills, this session will provide actionable tools to improve accuracy, reduce compliance risks, and support organizational success in value-based care.

Join us for an engaging, informative session that will equip you with the confidence and clarity needed to excel in today’s evolving risk adjustment environment.

Learning Objectives

• Explain the fundamentals of the CMS-HCC risk adjustment model and its impact on Medicare Advantage and other value-based programs
• Identify high-risk chronic conditions and documentation requirements necessary for accurate HCC coding
• Apply the MEAT (Monitor, Evaluate, Assess/Address, Treat) criteria to ensure compliant and thorough clinical documentation
• Recognize common coding errors and audit vulnerabilities that can negatively affect risk scores and organizational compliance
• Implement best practices for provider education and workflow optimization to enhance coding accuracy and efficiency
• Analyze recent CMS regulatory updates and RADV audit trends to stay ahead of compliance requirements
• Develop strategies for improving organizational performance in risk adjustment while reducing compliance risks and maximizing revenue integrity

Areas Covered in the Session

• Overview of the CMS-HCC Risk Adjustment Model
• High-Risk Chronic Conditions
• MEAT Criteria Application
• Common Coding Errors & Audit Vulnerabilities
• Best Practices for Provider Education & Workflow Optimization
• Regulatory Updates & RADV Audit Insights
• Strategies for Improving Organizational Performance
• Fraud and Abuse Risks
• Technology Integration
• Live Q&A Session

Suggested Attendees

• Healthcare Providers
• Medical Coders
• Certified Risk Adjustment Coders
• Biller
• Auditors
• CDIs
• ACOs
• Administrators
• Revenue Cycle Professionals
• Compliance Officers
• HIM Professionals
• Risk Adjustment Analysts
• Quality Improvement Teams
• Care Managers and Coordinators
• Medicare Advantage Staff
• Coding Supervisors and Managers
• Healthcare Consultants
• Practice Managers

About the Presenter

Keisha Wilson, CCS, CPC, CPCO, CPMA, CRC, CPB, AAPC Approved Instructor, the founder and CEO of KW Advanced Consulting, is a Minority Women-Owned Enterprise (M/WBE) and Economically Disadvantaged Women-Owned Small Business (EDWOSB) Certified professional with nearly 30 years of experience in healthcare. A seasoned leader and speaker at the HealthCon National and Regional Conference, Keisha’s career spans roles including outpatient coding specialist, CDI specialist, compliance operations manager, interim compliance director, and consultant.

An expert in Compliance and Revenue Cycle Management, Keisha specializes in risk-based audits, E/M auditing, multi-specialty coding, telehealth services, and Risk Adjustment/HCC education. She has developed and implemented comprehensive training programs for organizations of all sizes and is an approved instructor for KW Advanced Consulting, AAPC VILT, and NYC College of Technology.

Beyond her professional roles, Keisha serves on the Board of Directors for an outpatient mental health clinic and contributes to telehealth and compliance committees. She also Chair of the HDDH Working Group for the International Society for Telemedicine and eHealth (ISfTeH). She serves on the Advisory Board for The Nurses Pub and the HIM Department at South New Hampshire University (SNHU). A published author, she writes regularly for KW Advanced Consulting and collaborates with AAPC on coding articles and industry updates.

Additional Information:

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to talk and hear clearly

Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.

Can’t Listen Live?

No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:

Toll-Free No: 1-302-444-0162

Email: care@skillacquire.com

Address:- 651 N. Broad Street, Suite 206, Middletown, DE 19709

Testimonials:

"This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course"

Melissa Preston, Health Information Management Staff"David Vaughn covered the material completely and I have a new understanding of when, where and why we need to use an ABN"

Sandie Fowler, Out of Network Billing Staff"Great presentation. Able to do during the day. Timing was great"

Tina Duffy, Compliance Officer

All tickets include recording of the event.