Faster Billing and Fewer Errors: The Power of AI in Medical Coding
Client Profile
Challenges
- Increased Workload
A rise in patient visits led to a surge in medical records, overwhelming the coding team. - Accuracy Concerns
Human errors in coding resulted in billing discrepancies and potential revenue loss. - Time-Consuming Manual Coding
The manual process delayed reimbursement and created a backlog of uncoded records.
Solutions & Implementation
To address these challenges, the facility implemented a medical coding assistant (MCA) to automate and assist the coding team. Powered by natural language processing (NLP) and machine learning, the MCA analyzes medical records, extracts relevant data, and suggests appropriate codes.
- Data Integration
The MCA was securely integrated with the hospital’s electronic health record (EHR) system. - Training the MCA
Historical medical records were used to train the system, allowing it to learn patterns and correlations between clinical information and coding outcomes. - Real-Time Assistance
The MCA worked alongside human coders, providing real-time suggestions and code recommendations during the coding process. - Feedback Loop
Human coders provided continuous feedback, refining the MCA’s accuracy over time.
Technology and Tools
- Development Environment: Visual Studio 2022, Visual Studio Code, Power BI Desktop
- Front-End: Tailwind CSS v3.3.3, JavaScript, TypeScript v5.4.5, Angular v18.0.5, Material v18.0.5
- Data Visualization: Power BI Pro
- Backend: RESTful Web API services, .Net Framework 6.0, Entity Framework 4.0, Azure SQL Server
- Cloud Infrastructure: Microsoft Azure, Azure Multi-factor Authentication, Azure Blob storage, Microsoft Authenticator
- AI: Open AI API, Azure Open AI Studio, Azure Open AI Resource, Azure AI Search
- Version control: GIT, Azure DevOps
- Project Management tool: Azure Boards
Results
- Coding Faster, Billing Smarter: AI Assistant Boosts Efficiency and Accuracy for Healthcare Facility
With the integration of an AI-powered assistant, this healthcare facility achieved faster reimbursements, minimized errors, and streamlined its workflow. Discover how AI revolutionized their medical coding process, driving efficiency and improving billing accuracy. - Medical Coding Transformed: AI-Driven Efficiency and Accuracy for Healthcare Facility
Medical coding plays a critical role in healthcare administration, ensuring the precise documentation and billing of medical services. With the growing volume of healthcare data, providers face increasing pressure to manage coding tasks efficiently. This case study details the successful implementation of a Medical Coding Assistant (MCA) to streamline and enhance the coding process at a healthcare facility. - Increased Efficiency
The MCA accelerated coding, enabling the team to process more records daily. - Improved Accuracy
The MCA reduced coding errors, minimizing billing discrepancies and audit risks. - Reduced Backlog
The backlog of un-coded records was cleared, speeding up reimbursement and improving cash flow.
- Cost Savings
Automation reduced manual effort, leading to optimized resource usage and lower overtime costs.
Conclusion
Everest Consultants successfully enabled the client to meet the challenges of regulatory compliance in a fast-paced, highly regulated industry. Through automation, strategic test case development, and rigorous QA processes, we delivered a robust solution that improved operational efficiency, minimized risk, and ensured ongoing compliance in a complex environment.
Everest's Expertise
With over 25 years of experience and a global team of experts, Everest delivers innovative solutions for client success. Whether it’s custom application development, engineering services, or offshore outsourcing, Everest empowers businesses to optimize their operations and achieve their goals.