CMS Reimbursement

Tecks has developed numerous applications for use in the health care sector. Of them, are tools used by Clinical Auditing teams for obtaining accurate Centers for Medicare & Medicaid Services reimbursements. These tools work by first capturing member/patient diagnosis information by entering disease classification codes into the system.

Tecks has developed numerous applications for use in the health care sector. Of them, are tools used by Clinical Auditing teams for obtaining accurate Centers for Medicare & Medicaid Services (CMS) reimbursements. These tools work by first capturing member/patient diagnosis information by entering disease classification codes (ICD-9 codes) into the system.  The description, HCC, and RxHCC scores associated with the entered ICD-9 codes are then automatically populated. This information is in turn used by the Health Plan and Insurance companies for payment reimbursement through Medicaid/Medicare. For more information about risk adjustment approaches and CMS Reimbursement, please see Risk Adjustment.