The US medical coding market is experiencing phenomenal growth and is forecasted to expand at a compound annual growth rate (CAGR) of 8.0% from 2022 to 2030.
– Grand View Research
Bidding Adieu to Manual Processes
- Increased Claims Denials/ Delays
- Impacted Revenues
- HIPAA Violations
- Legal Lawsuits and Federal Fines
- Compromised Patient Satisfaction
- Increase in Medical Debt
- Coder Fatigue and more…
In 2021, around 90% of the denied claims could be avoided. This part of the claim denials would have translated to about $235 billion as annual revenue for the American medical industry, according to a report by Healthcare Financial Management Association (HFMA).
Decoding Medical Coding Challenges with Technology
AI Use Case: Intelligent Z Code Extraction and Contextual Mapping
- The platform identified the ICD/Z Codes automatically
- It also identified the key phrases in the EHR document against these ICD/Z Code descriptions
- Natural Language Processing (NLP) delivered contextual matches of the key phrases with the content
- The technology extracted portions/phrases from the EHR document that matched the key phrases along with the matching score. It supported multiple types of docs (.pdf,.doc, .TXT, and OUT).
- It created a top N recommended set of extracted phrases from the document that had the highest matching score
- And, displayed matching content with mapped ICD/Z Code in a UI
Leveraging AI to Achieve the 3Cs of Medical Coding
Moving Forward with AI
Anand Subramaniam is the Chief Solutions Officer, leading Data Analytics & AI service line at KANINI. He is passionate about data science and has championed data analytics practice across start-ups to enterprises in various verticals. As a thought leader, start-up mentor, and data architect, Anand brings over two decades of techno-functional leadership in envisaging, planning, and building high-performance, state-of-the-art technology teams.