New HCC Coding Edit Suite will support health systems with risk-based contracts
MOBILE, Ala.--(BUSINESS WIRE)--The SSI Group, a leader in financial performance solutions for providers and payers, announced today a partnership with RCxRules, a leading provider of automated billing solutions for healthcare organizations' population health and revenue cycle operations. As a part of the partnership, the two companies are launching the HCC Coding Edit Suite which will help large health systems to financially succeed with risk-based contracts such as Medicare Shared Savings, Medicare Advantage and Managed Medicaid.
According to the American Academy of Professional Coders, medical groups fail to report more than 40% of their patient's active chronic conditions. Inaccurate HCC (Hierarchical Condition Categories) coding directly impacts the reimbursement healthcare organizations receive and can lead to a significant financial loss for any given health system. The HCC Coding Edit Suite from SSI and RCxRules will help identify HCC Coding gaps for coder review, ensuring the capture of accurate and appropriate HCC codes. By including the most accurate HCC codes, the solution ensures Risk Adjustment Factor (RAF) scores align with patient’s health.
“RCxRules is thrilled to partner with SSI as they share our strong focus on customer success and our commitment to developing solutions that improve the financial health of our customers,” said Stephen Gorman, CEO at RCxRules. “SSI’s exceptional technology platform and marquee customer base, combined with RCxRules’ innovative HCC Coding technology, will fuel growth for both organizations as we help customers excel with their Medicare Advantage and value-based care contracts.”
The health care industry continues to make significant shifts towards value-based care, with the New England Journal of Medicine recently predicting that this model can help solve significant cost and quality problems. Additionally, as health systems move towards consolidating vendors, the partnership between SSI and RCxRules will support appropriate quality measures and cost performance.
“Access to actionable data is key for every organization we partner with,” said Diana Allen, CEO of The SSI Group. “We are excited about this partnership with RCxRules and look forward to supporting our customers in their efforts to improve overall revenue growth.”
About The SSI Group (SSI)
SSI is nationally recognized for excellence in healthcare revenue cycle management solutions. Recently, SSI ranked No. 1 for revenue cycle claims management software by KLAS in the 2020 “Best in KLAS” report, receiving a score of 93. The Category Leader designation is based on a review of interviews conducted with more than 30,000 payers and health systems. This is the fourth time in eight years SSI has received the Category Leader designation from KLAS for revenue cycle claims management software. For more information about SSI’s solutions and services, visit www.thessigroup.com.
Founded in 2010, RCxRules helps healthcare organizations succeed with both value-based care and fee-for-service billing models. The automation technology ensures compliance and coding accuracy with healthcare's complex regulatory and reimbursement rules. RCxRules addresses coding issues before they impact revenue and delivers claims with the most accurate financial and HCC data—every time, guaranteed. For more information, visit https://www.rcxrules.com.
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