HCC Management Solutions

At Focus Care we understand providers and plans mission to deliver exceptional quality care for their members, while maximizing their efficiency and revenue. That is why Focus Care is THE ONE health care services company that maintains a continuum of HCC Management services all in one place.

As a total solution partner for providers and plans, Focus Care takes managed care one step further to maximize your business success. Driven by our commitment to revenue optimization and efficient member service, Focus Care delivers a network of nursing utilization methods unmatched in the industry.

Identifying the appropriate members for Health Risk Assessments continues to be a struggle for Health Plans and ACOs. Focus Care eliminates this dilemma by successfully identifying members through predictive modeling, there by obtaining a high conversion and member engagement rate.

Focus Care offers a full array of a la carte services for prospective evaluations, including:

Member Identification

Risk Adjustment/HCC Coding/
ROI Analysis

  • Support Medicare Advantage plans in completing accurate risk assessment of their membership and submit complete and accurate data before CMS deadlines.
  • Correct coding to the highest specificity, based on documentation to maximize risk scores
  • Validate documentation on all diagnosis codes in charts and codes hitting HCCs
  • Report of Missed/Suspect/Embedded codes
  • Validate documentation on submitted and paid HCCs by CMS
  • Quality Assurance team to process and review all completed evaluations
  • Electronic capability to securely transmit assessments to clients and regulatory agencies
  • Data Quality Assurance and Customizable Client Reporting
  • On Shore as well as lower cost Off Shore Coding capabilities

Member Outreach Supported by
Robust Nationwide Provider Network