Autonomous medical coding is revolutionizing revenue cycle management. Medical coding is the process of transforming healthcare diagnoses, procedures, and medical services into standardized codes. CPT and ICD-10 codes are the most common types of medical codes used in today's healthcare industry. For example, you break your leg and it requires surgery to be fixed. You visit your local emergency department and they code ICD S82 (fracture of lower leg including ankle) and CPT 27792 (fracture and/or dislocation procedures on the leg). Traditionally, a human medical coder would read the information provided in the electronic health record to determine that you broke your leg and received surgery and apply those specific codes set to your claim. That claim would then be sent off for billing processing for the hospital to receive payment. This is time-consuming, tedious, and prone to errors. However, with the advent of technology, medical coding can become more efficient and accurate.
Autonomous medical coding technology is the latest advancement in medical coding. It is a type of artificial intelligence (AI) that automates the coding process, reducing the need for human coders, which are currently in short supply. Medical coders are not exempt from the great clinician shortage, and as demand increases for those positions, the supply has dwindled. In fact, in a recent study completed by The Health Management Academy, 78% of healthcare executives reported they are evaluating AI-based tools for their revenue cycle management processes. In this article, we will explore the benefits of autonomous medical coding technology and how it is revolutionizing the healthcare industry.
1. Increased Accuracy: Autonomous medical coding technology uses machine learning to accurately identify and extract relevant medical codes from clinical documentation. Autonomous solutions are automatically updated with the latest rules and guidelines for payers. They can immediately learn these changes and incorporate them, a task that would take human coders significantly more time. This technology has been shown to reduce coding errors and improve accuracy.
2. Faster Coding: Autonomous medical coding technology can process large amounts of medical data quickly and efficiently. Autonomous solutions never take a day off. They continue to run and process claims every second of every day. This causes drastically reduced turnaround times and It reduces the need for human coders, which saves time and resources.
3. Cost-Effective: Autonomous medical coding technology is cost-effective because it reduces the need for human coders, which are in short supply. This technology can process large amounts of data quickly and efficiently, which saves time and reduces costs. Currently, 25-30% of US healthcare spending is spent on administrative tasks, with medical coding being the most expensive of the revenue cycle. Coding-related denials are on the rise again this year, increasing to nearly 11% of all claims. Denials cost institutions and payer time and money and require extra effort to be reworked. Autonomous coding can drastically reduce turnaround time as well as coding-related denials which improve healthcare organizations' bottom line.
4. Increased Efficiency: Autonomous medical coding technology can work 24/7, which increases efficiency and productivity. It can process large volumes of data quickly and accurately, which frees up human coders to focus on other tasks. Imagine a system that codes like your best coder 24/7/365.
5. Improved Healthcare Quality: Autonomous medical coding technology can improve the quality of healthcare by providing accurate and timely medical coding. Today, it is nearly impossible for human coders to code with clinical specificity. Autonomous coding can not only code more quickly, but it can code with a high degree of clinical specificity that has simply not been cost-effective until now. This can lead to better patient outcomes and improved healthcare delivery.
Autonomous medical coding technology uses AI and machine learning algorithms to process clinical documentation and assign appropriate medical codes. Here's how it works:
1. Data Extraction: The technology extracts relevant data from clinical documentation, including medical reports, diagnoses, and procedures from within the EHR.
2. Code Assignment: The technology uses machine learning to analyze the data and assign appropriate medical codes. This technology learns over time and continuously improves.
3. Quality Assurance: The technology uses quality assurance checks to ensure that the codes assigned are accurate and relevant.
4. Integration: The technology integrates with electronic health record (EHR) systems, medical billing software, and other healthcare IT systems.
Q. What are the benefits of autonomous medical coding technology?
A. Autonomous medical coding technology offers increased accuracy, faster coding, cost-effectiveness, increased efficiency, and improved healthcare quality.
Q. How does autonomous medical coding technology work?
A. Autonomous medical coding technology uses AI and machine learning algorithms to process clinical documentation and assign appropriate medical codes.
Q. Can autonomous medical coding technology completely replace human coders?
A. While autonomous medical coding technology can significantly reduce the need for human coders, it cannot completely replace them. Human coders are still required to review and validate the codes assigned by the technology. Most healthcare organizations have many coding positions that they can not currently fill. This technology can provide relief to those institutions.
Q. Is autonomous medical coding technology secure?
A. Yes, autonomous medical coding technology is secure. It adheres to strict privacy and security protocols to protect patient data.
CodaMetrix unlocks knowledge from the EHR and uses it to add value to healthcare providers. The CMX platform leverages artificial intelligence in the form of machine learning, deep learning, and natural language processing to continuously learn from and act upon the clinical evidence in the EHR. We automatically and autonomously translate clinical notes into billing codes that satisfy coding requirements, ensuring claims consistently represent the unique and complete episode of care while reducing the human coding workload.
The CMX platform provides medical coders with more intuitive and integrated decision support, and will later eliminate the administrative burden of HCC coding and prior authorization requirements. Born out of MassGeneral Brigham and designed by revenue cycle experts, CodaMetrix is dedicated to eliminating administrative burden that hinders physicians and the financial management of high-quality care.
Autonomous medical coding technology is the future of medical coding. It offers increased accuracy, faster coding, cost-effectiveness, increased efficiency, and improved healthcare quality. This technology is transforming the healthcare industry by reducing the need for human coders and improving the overall efficiency of medical coding. As this technology continues to evolve, we can expect to see even more advancements in the field of medical coding.
