Automating medical codes using Artificial Intelligence (AI) has been in the works for over 10 years. As the medical industry prepared for the huge transformation from ICD-9 to ICD-10, Health Information Management (HIM) departments needed to embrace automation to help in the transition without affecting their bottom line.
As AI developed, so did deep learning. The moment that the generative AI models were created, we are now entering the next wave of huge technological advancements to completely automate the workflows of coding. The main focus is on tackling the shortage of coders and tough budget issues that have increased in the past five years. Enter autonomous coding.
How does the autonomous medical code function?
Automated medical coders use modern technology to completely automate the coding process. They are run in the background, performing a test of coded patient encounters for all patients and submitting all chart codes to billing with no human intervention. This is a major improvement over other solutions, such as CAC, which requires medical coders to verify the coding output prior to the encounter being transferred to billing.
The technology behind self-contained medical codes differs according to the vendor. Most solutions use multiple subfields within AI, including natural machine learning, language processing, and deep learning. These tools allow self-coding solutions that can accurately read the clinical information found in patients’ medical records and convert that information into the appropriate medical codes.
How was that the autonomous medical code created?
The process of medical coding has not changed much since its beginning around 50 years ago, with a lot of healthcare providers relying on medical coders who are certified to review the codes assigned to encounters with patients. While computer-assisted coding and encoding (CAC) options have come up to assist medical coders, an approach that relies on manual coding has become increasingly inconvenient over the last few years, as the field has a shortage of medical coders, and more complex codes for payers and policies.
The industry’s challenges are driving more administrative burdens, payment delays, and compliance issues, which ultimately impact the operational and financial performance of hospitals, health systems providers, hospitals, and other healthcare institutions. In addition, since healthcare organizations run on extremely tight margins, it’s not a surprise that revenue cycle and coding managers need the latest medical coding technology.
What are the advantages of autonomous medical codes?
Autonomous medical coding solutions fully automate the process of medical coding and provide healthcare providers with unimaginable economic and operational benefits.
Financial Benefits
Reduces Coding-Related Costs. Autonomous medical coding solutions can cut down on FTE (FTE) expenses and other coding-related labor costs by automating coding for significant patient interactions.
Automates Payment Cycles: Automated medical coding solutions allow for coding patient encounters in seconds, reducing the chance of high DNFC quantity and coding backlogs. The end result is fewer days of accounts receivable, which decreases the chance of cash flow problems such as bad debt, higher interest rates, and other financial worries.
Ensures compliance and high-quality coding. The autonomous medical coding systems are regularly updated to keep up with regulators and payers’ and most recent coding guidelines. Organisations that ensure that providers are properly compensated for their services, while at the same time cutting down the possibility of code-related denials, excessive coding, or undercoding. This results in accurate revenue capture and significant savings because of the reduced labor required to work on claims and support audits.
