What may auditing HCC practices require?

• A. Additional patient visits.
• B. Increased documentation budgets.
• C. No changes needed.
• D. Adjustments or penalties.

Answer: (D)

Auditing HCC practices focuses on making sure the documentation supports the codes that were billed and that payments reflect the patient’s true risk. When an audit uncovers mismatches or unsupported codes, the typical outcome is a financial adjustment—claims may be corrected or recouped, and the risk score can be downcoded. In cases of clear misreporting or fraud, penalties may be imposed to reinforce compliance. So, adjustments or penalties are the natural consequences of validating accuracy in HCC coding.

Other options don’t directly describe what audits enforce. Audits aren’t about forcing additional patient visits or mandating higher documentation budgets; nor do they imply that no changes are needed. The focus is on ensuring accurate billing and, when needed, correcting or penalizing for inaccuracies.