The digitization of health records coupled with the increasing capability of Natural Language Processing has made autonomous coding possible. The main benefit of this technology is not the potential cost reductions, but rather the potential improvement in revenue that it brings.
Medical Coding
According to the American Health Information Management Association (AHIMA), Coding Specialists “create coded data used by hospitals and medical providers to obtain reimbursement from insurance companies or government programs such as Medicare and Medicaid.” They do this by reviewing patient records and assigning numeric codes for each diagnosis and procedure.
Prior to the pandemic, medical coding was one of the top 20 most in-demand jobs in the US according to the Bureau of Labor Statistics (BLS). It was difficult for healthcare organizations (especially mid-sized practices) to find and keep good coders. Not only could they find better paying jobs elsewhere, but good coders were often promoted to senior roles in the organization. As a result of this, many organizations outsourced the coding function.
Automating repetitive tasks is one way to deal with this coding workforce challenge.
Autonomous Coding
According to Neal Somaney, Executive Vice President at CorroHealth, autonomous coding is a viable technology that can automate portions of the coding process.
“By applying special Natural Language Processing (NLP) algorithms developed in-house we can automate the charge capture part of the process,” Somaney said in an interview with Healthcare IT Today. “We can also derive the ICD codes which can go straight into an organization’s billing system.”
Here is a high-level diagram that shows how it works:
With autonomous coding, charts can be processed in seconds and the total turn-around time can be a little as a few minutes. Organizations would no longer have to wait until the next day to get their coding back from their outsourced coding partner.
In a year-long pilot with a client, CorroHealth found that their autonomous coding solution could successfully automate charge capture for 95% of charts which translated into a 700% productivity gain.
Impact on Revenue
The impact autonomous coding has on revenue is one of the top benefits of the technology. The software can work late into the night and over the weekend which means that claims can be submitted to payors sooner which accelerates time-to-cash. This can be critical for healthcare organizations facing cash flow challenges.
“In addition, autonomous coding helps reduce rejections because the technology produces consistent results,” explained Somaney. “Fewer claims issues means more revenue faster and less headaches.”
Impact on the Role Coding Specialists
It would be easy for coding specialists to be fearful of autonomous coding. On the surface this technology has the ability to replace them, but that belies the fact that humans are still needed as part of the coding process.
“With autonomous coding, coding specialists can be elevated to the role of auditor,” said Somaney. “The software can now be the coder leaving the specialist to deal with edge cases, exceptions and unexpected changes. This type of work is far more engaging and stimulating.”
That in turn, could help with the retention challenge. After all, why would someone leave an organization that is investing in technology that makes the process smoother and less frustrating?
“Healthcare changes quickly,” continues Somaney. “We will always need people to help us adapt to those changes.”
Gaining Traction
Although autonomous coding is not a new concept, it is only starting to gain traction now. This is partly due to skepticism over the technology.
To address this, Somaney strongly encourages autonomous coding vendors to not over-hype the technology: “Autonomous coding can really help with certain chart types and the technology is still evolving. It is important not to over-sell what it can do.”
Somaney recommends that HIM and IT leaders in healthcare organizations see the technology running first-hand.
Watch the full interview with Somaney to learn:
- What CorroHealth is working on next
- Why reaching an inflection point with EHRs was necessary for the rise of autonomous coding
- The impact that ICD-10 had on coding specialists and the technologies that support them
CorroHealth is a sponsor of Healthcare IT Today. For more information visit https://corrohealth.com/
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