HCCs without Supporting Documentation Sample Clauses

HCCs without Supporting Documentation. Any HCCs for which Cigna cannot produce medical record documentation that meets CMS’s Criteria for Risk Adjustment Eligible Diagnoses shall be considered an error and the total payment received by Cigna for that HCC shall be deemed an Overpayment. Replacement sampling for Risk Adjustment Members for whom Cigna could not produce medical record documentation that meets CMS’s Criteria for Risk Adjustment Eligible Diagnoses is not permitted.