POST rest/HccRiskScore/GetHccRiskScores
Calculate the HCC Risk Score based on the patient demographic information and diagnosis codes available in the request.
Request Information
URI Parameters
None.
Body Parameters
HCC Risk Score Calculation request.
HCCRiskScoreRequest| Name | Description | Type | Additional information |
|---|---|---|---|
| version |
API version number (either '1.0' or '1.1') |
string |
Required |
| clientId |
The GUID format of Client ID. This value is provided by Madicare Informatics after registration. |
string |
Required |
| paymentMonth |
Payment Month in "yyyy-MM" format (Default: 2019-02). Payment date is used to calculate age (Age = The First Day of Payment Month - Date of Birth). |
date |
Required Data type: DateTime |
| frailty |
Frailty Indicator (Included or NotIncluded). Not used in version '1.0'. |
FrailtyIndicator |
Required |
| patients |
Collection of patient demographic information and diagnosis codes to be used for HCC risk score calculation. |
Collection of HCCRiskScoreRequestPatient |
Required |
Request Formats
application/json, text/json
Sample:
{
"version": "sample string 1",
"clientId": "sample string 2",
"paymentMonth": "2024-12-25T15:49:20.6591287+00:00",
"frailty": 0,
"patients": [
{
"requestId": "sample string 1",
"age": 2,
"gender": 0,
"enrollee": 0,
"model": 98,
"segment": 0,
"medicaid": 0,
"eligibility": 0,
"income": 0,
"kidney": 0,
"graft": 1,
"disabled": true,
"codes": [
"sample string 1",
"sample string 2"
]
},
{
"requestId": "sample string 1",
"age": 2,
"gender": 0,
"enrollee": 0,
"model": 98,
"segment": 0,
"medicaid": 0,
"eligibility": 0,
"income": 0,
"kidney": 0,
"graft": 1,
"disabled": true,
"codes": [
"sample string 1",
"sample string 2"
]
}
]
}
application/xml, text/xml
Sample:
<HCCRiskScoreRequest xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://schemas.datacontract.org/2004/07/MediProvider.Models">
<clientId>sample string 2</clientId>
<frailty>Included</frailty>
<patients>
<HCCRiskScoreRequestPatient>
<age>2</age>
<codes xmlns:d4p1="http://schemas.microsoft.com/2003/10/Serialization/Arrays">
<d4p1:string>sample string 1</d4p1:string>
<d4p1:string>sample string 2</d4p1:string>
</codes>
<disabled>true</disabled>
<eligibility>Aged</eligibility>
<enrollee>ContinuingEnrollee</enrollee>
<gender>Male</gender>
<graft>OneMonth</graft>
<income>LowIncome</income>
<kidney>Dialysis</kidney>
<medicaid>None</medicaid>
<model>CMSHCCv28</model>
<requestId>sample string 1</requestId>
<segment>Community</segment>
</HCCRiskScoreRequestPatient>
<HCCRiskScoreRequestPatient>
<age>2</age>
<codes xmlns:d4p1="http://schemas.microsoft.com/2003/10/Serialization/Arrays">
<d4p1:string>sample string 1</d4p1:string>
<d4p1:string>sample string 2</d4p1:string>
</codes>
<disabled>true</disabled>
<eligibility>Aged</eligibility>
<enrollee>ContinuingEnrollee</enrollee>
<gender>Male</gender>
<graft>OneMonth</graft>
<income>LowIncome</income>
<kidney>Dialysis</kidney>
<medicaid>None</medicaid>
<model>CMSHCCv28</model>
<requestId>sample string 1</requestId>
<segment>Community</segment>
</HCCRiskScoreRequestPatient>
</patients>
<paymentMonth>2024-12-25T15:49:20.6591287+00:00</paymentMonth>
<version>sample string 1</version>
</HCCRiskScoreRequest>
application/x-www-form-urlencoded
Sample:
Sample not available.
Response Information
Resource Description
HCCRiskScoreResponse| Name | Description | Type | Additional information |
|---|---|---|---|
| version |
API response version number (either '1.0' or '1.1'). Usually, the response version number is same the request version number. |
string |
Required |
| clientId |
The GUID format of Client ID. This value is provided by Madicare Informatics after registration. The reponse Client ID must be same as the request Client ID. |
string |
Required |
| errMsg |
Error message describes why it failed. |
string |
Required |
| patients |
The collection of patients' response. |
Collection of RiskScorePatientDetail |
Required |
Response Formats
application/json, text/json
Sample:
{
"version": "sample string 1",
"clientId": "sample string 2",
"errMsg": "sample string 3",
"patients": [
{
"requestId": "sample string 1",
"demographics": [
{
"code": "sample string 1",
"desc": "sample string 2",
"score": 3.1
},
{
"code": "sample string 1",
"desc": "sample string 2",
"score": 3.1
}
],
"interactions": [
{
"code": "sample string 1",
"desc": "sample string 2",
"score": 3.1
},
{
"code": "sample string 1",
"desc": "sample string 2",
"score": 3.1
}
],
"diags": [
{
"code": "sample string 1",
"desc": "sample string 2",
"hccs": [
{
"hcc": 1,
"code": "sample string 2",
"desc": "sample string 3",
"drop": true,
"reason": "sample string 5",
"score": 6.1
},
{
"hcc": 1,
"code": "sample string 2",
"desc": "sample string 3",
"drop": true,
"reason": "sample string 5",
"score": 6.1
}
]
},
{
"code": "sample string 1",
"desc": "sample string 2",
"hccs": [
{
"hcc": 1,
"code": "sample string 2",
"desc": "sample string 3",
"drop": true,
"reason": "sample string 5",
"score": 6.1
},
{
"hcc": 1,
"code": "sample string 2",
"desc": "sample string 3",
"drop": true,
"reason": "sample string 5",
"score": 6.1
}
]
}
],
"demographicFactor": 2.1,
"diseaseFactor": 3.1,
"paymentCount": {
"count": 1,
"code": "sample string 2",
"desc": "sample string 3",
"score": 4.1
},
"rawScore": 4.1,
"normalizationFactor": 5.1,
"normalizedScore": 6.1,
"codingIntensityFactor": 7.1,
"adjustedScore": 8.1
},
{
"requestId": "sample string 1",
"demographics": [
{
"code": "sample string 1",
"desc": "sample string 2",
"score": 3.1
},
{
"code": "sample string 1",
"desc": "sample string 2",
"score": 3.1
}
],
"interactions": [
{
"code": "sample string 1",
"desc": "sample string 2",
"score": 3.1
},
{
"code": "sample string 1",
"desc": "sample string 2",
"score": 3.1
}
],
"diags": [
{
"code": "sample string 1",
"desc": "sample string 2",
"hccs": [
{
"hcc": 1,
"code": "sample string 2",
"desc": "sample string 3",
"drop": true,
"reason": "sample string 5",
"score": 6.1
},
{
"hcc": 1,
"code": "sample string 2",
"desc": "sample string 3",
"drop": true,
"reason": "sample string 5",
"score": 6.1
}
]
},
{
"code": "sample string 1",
"desc": "sample string 2",
"hccs": [
{
"hcc": 1,
"code": "sample string 2",
"desc": "sample string 3",
"drop": true,
"reason": "sample string 5",
"score": 6.1
},
{
"hcc": 1,
"code": "sample string 2",
"desc": "sample string 3",
"drop": true,
"reason": "sample string 5",
"score": 6.1
}
]
}
],
"demographicFactor": 2.1,
"diseaseFactor": 3.1,
"paymentCount": {
"count": 1,
"code": "sample string 2",
"desc": "sample string 3",
"score": 4.1
},
"rawScore": 4.1,
"normalizationFactor": 5.1,
"normalizedScore": 6.1,
"codingIntensityFactor": 7.1,
"adjustedScore": 8.1
}
]
}
application/xml, text/xml
Sample:
<HCCRiskScoreResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://schemas.datacontract.org/2004/07/MediProvider.Models">
<clientId>sample string 2</clientId>
<errMsg>sample string 3</errMsg>
<patients>
<RiskScorePatientDetail>
<adjustedScore>8.1</adjustedScore>
<codingIntensityFactor>7.1</codingIntensityFactor>
<demographicFactor>2.1</demographicFactor>
<demographics>
<RiskScoreDemographic>
<code>sample string 1</code>
<desc>sample string 2</desc>
<score>3.1</score>
</RiskScoreDemographic>
<RiskScoreDemographic>
<code>sample string 1</code>
<desc>sample string 2</desc>
<score>3.1</score>
</RiskScoreDemographic>
</demographics>
<diags>
<RiskScoreDiagnosisDetail>
<code>sample string 1</code>
<desc>sample string 2</desc>
<hccs>
<RiskScoreHccDetail>
<code>sample string 2</code>
<desc>sample string 3</desc>
<drop>true</drop>
<hcc>1</hcc>
<reason>sample string 5</reason>
<score>6.1</score>
</RiskScoreHccDetail>
<RiskScoreHccDetail>
<code>sample string 2</code>
<desc>sample string 3</desc>
<drop>true</drop>
<hcc>1</hcc>
<reason>sample string 5</reason>
<score>6.1</score>
</RiskScoreHccDetail>
</hccs>
</RiskScoreDiagnosisDetail>
<RiskScoreDiagnosisDetail>
<code>sample string 1</code>
<desc>sample string 2</desc>
<hccs>
<RiskScoreHccDetail>
<code>sample string 2</code>
<desc>sample string 3</desc>
<drop>true</drop>
<hcc>1</hcc>
<reason>sample string 5</reason>
<score>6.1</score>
</RiskScoreHccDetail>
<RiskScoreHccDetail>
<code>sample string 2</code>
<desc>sample string 3</desc>
<drop>true</drop>
<hcc>1</hcc>
<reason>sample string 5</reason>
<score>6.1</score>
</RiskScoreHccDetail>
</hccs>
</RiskScoreDiagnosisDetail>
</diags>
<diseaseFactor>3.1</diseaseFactor>
<interactions>
<RiskScoreInteraction>
<code>sample string 1</code>
<desc>sample string 2</desc>
<score>3.1</score>
</RiskScoreInteraction>
<RiskScoreInteraction>
<code>sample string 1</code>
<desc>sample string 2</desc>
<score>3.1</score>
</RiskScoreInteraction>
</interactions>
<normalizationFactor>5.1</normalizationFactor>
<normalizedScore>6.1</normalizedScore>
<paymentCount>
<code>sample string 2</code>
<count>1</count>
<desc>sample string 3</desc>
<score>4.1</score>
</paymentCount>
<rawScore>4.1</rawScore>
<requestId>sample string 1</requestId>
</RiskScorePatientDetail>
<RiskScorePatientDetail>
<adjustedScore>8.1</adjustedScore>
<codingIntensityFactor>7.1</codingIntensityFactor>
<demographicFactor>2.1</demographicFactor>
<demographics>
<RiskScoreDemographic>
<code>sample string 1</code>
<desc>sample string 2</desc>
<score>3.1</score>
</RiskScoreDemographic>
<RiskScoreDemographic>
<code>sample string 1</code>
<desc>sample string 2</desc>
<score>3.1</score>
</RiskScoreDemographic>
</demographics>
<diags>
<RiskScoreDiagnosisDetail>
<code>sample string 1</code>
<desc>sample string 2</desc>
<hccs>
<RiskScoreHccDetail>
<code>sample string 2</code>
<desc>sample string 3</desc>
<drop>true</drop>
<hcc>1</hcc>
<reason>sample string 5</reason>
<score>6.1</score>
</RiskScoreHccDetail>
<RiskScoreHccDetail>
<code>sample string 2</code>
<desc>sample string 3</desc>
<drop>true</drop>
<hcc>1</hcc>
<reason>sample string 5</reason>
<score>6.1</score>
</RiskScoreHccDetail>
</hccs>
</RiskScoreDiagnosisDetail>
<RiskScoreDiagnosisDetail>
<code>sample string 1</code>
<desc>sample string 2</desc>
<hccs>
<RiskScoreHccDetail>
<code>sample string 2</code>
<desc>sample string 3</desc>
<drop>true</drop>
<hcc>1</hcc>
<reason>sample string 5</reason>
<score>6.1</score>
</RiskScoreHccDetail>
<RiskScoreHccDetail>
<code>sample string 2</code>
<desc>sample string 3</desc>
<drop>true</drop>
<hcc>1</hcc>
<reason>sample string 5</reason>
<score>6.1</score>
</RiskScoreHccDetail>
</hccs>
</RiskScoreDiagnosisDetail>
</diags>
<diseaseFactor>3.1</diseaseFactor>
<interactions>
<RiskScoreInteraction>
<code>sample string 1</code>
<desc>sample string 2</desc>
<score>3.1</score>
</RiskScoreInteraction>
<RiskScoreInteraction>
<code>sample string 1</code>
<desc>sample string 2</desc>
<score>3.1</score>
</RiskScoreInteraction>
</interactions>
<normalizationFactor>5.1</normalizationFactor>
<normalizedScore>6.1</normalizedScore>
<paymentCount>
<code>sample string 2</code>
<count>1</count>
<desc>sample string 3</desc>
<score>4.1</score>
</paymentCount>
<rawScore>4.1</rawScore>
<requestId>sample string 1</requestId>
</RiskScorePatientDetail>
</patients>
<version>sample string 1</version>
</HCCRiskScoreResponse>