Medical coding is translating detailed medical reports into a specific type of short code (CPT or CDT codes) recognized throughout the healthcare industry. Medical coding aims to convert complicated healthcare reports into efficient, easy-to-interpret codes to file claims to send to payers. Medical coding software is used to generate codes automatically from clinical reports. It accelerates the entire coding process and uses automation to minimize human intervention, thus minimizing the chances of errors. Software for medical billing and coding helps increase revenues for providers.
Automated coding data extraction is the process of abstracting the coded data elements from patient records for a pre-defined user process. This data extraction using medical coding solutions may help in a broad spectrum of functionalities such as outcome measures, performance monitoring, RAC audits, CDC reporting, Joint Commission Core Measures, hospital-acquired conditions, and clinical registries (e.g., cancer, birth).
The structured inputs are required for automated medical coding data extraction. As per the requirement, we can leverage high-quality technology stack in a medical coding system to combine concepts in terms of morphology, syntax, semantics, and real-world knowledge. Through automated data extraction, our medical coding system can perform medical indexing, medical classification, mapping of clinical and non-clinical medical terminologies, quality enhancements for clinical concept extraction, quality Assurance for clinical coding, and more. This can aid in minimizing coding errors, false positives, and false negatives.
With integrated ICD-10 coding data, the encoder software for medical coding can offer automated medical code generation for the healthcare providers. These automated suggestions provide medical codes for review, verification, and application based on the clinical documentation presented by the practitioners. The system has the capability to search for particular diagnostic statements and unique terms and/or abbreviations within the given medical document. Natural language processing (NLP) is applied to a text documents that employ computational linguistics and AI to obtain appropriate coding data and terms to convert them into a set of accurate medical codes.
OSP has the potential to design the best medical coding software that can assign medical codes from a pre-defined classification system to the diagnoses generated at the clinic or hospitals. The custom-made encoder software can easily identify ICD-10, CPT and CDT codes, and even nomenclature codes, such as LOINC, RxNorm, and SNOMED-CT for laboratory, pharmaceutical, and clinical documents, respectively.
Automated medical coding is the modern medical coding software that helps in speeding up the coding process workflow and ensure better accuracy. Most medical coding software companies are focusing on the medical coding solution automation to replace the traditional, paper-based coding system. It eliminates manual handoffs and improves staff productivity by driving accurate and efficient coding for the ambulatory health care industry segments.
We can build a made-to-order encoder software for medical coding where each claim to be submitted is thoroughly reviewed and scrubbed. It is checked by payer-specific rules, cross-reviewed for patient and health plan identification and examined to ensure accurate coding. With a simple and intuitive interface and robust reporting functionalities can help you monitor performance towards success.
Hierarchical Condition Category (HCC) coding model was initiated by CMS for risk adjustment and evaluate future health care costs for patients. Due to the shift to the value-based payment models, the HCC coding is highly prevalent. Our HCC risk adjustment coding relies on hospital outpatient, principal hospital inpatient, secondary hospital inpatient, physician, and trained non-physician.
OSP’ custom medical coding solutions can comprehensively assess the current status of HCC capture rates of your healthcare provider organization through smarter claims data analysis and medical record review. This can aid in finding the gaps in optimum HCC capture and can help in improving the capture, medical coding quality, and overall revenue collection through the healthcare payment system. Our medical coding solution incorporates focused chart review, chart audit summary reports, HCC validation through RADV audit, and report of missing/embedded codes.
Today’s healthcare provider organizations and medical practices struggle to ensure a good quality medical coding system that provides complete and accurate documentation and compliant coding process. With highly complex ICD-10 codings, government legislation, and regulations, the best medical coding software is in demand. To comply with all the required compliances and reduce claim denials, medical coding solutions should incorporate periodic medical coding and documentation audit module.
OSP can customize automated coding audit module in medical coding software to minimize risk and regulatory exposure and receive appropriate reimbursements. Our coding audit system helps you streamline HIPAA-compliant audit workflow with HIM-level reporting and accuracy scores. The coding auditing will support in ensuring the coder compliance with new regulatory requirements to mitigate risk and implement industry standards and best practices to enhance performance.
A real-time and intuitive medical coding solutions dashboard can promote the qualitative coding, analysis and reporting at a better scale. The process workflow management, performance monitoring, coding audits, HCC coding analysis can be understood and enhanced with an easy-to-use dashboard for encoder software for medical coding.
We simplify the computer-assisted coding process and help you improve your productivity by providing a clear picture of coding performance and accuracy through real-time dashboards. You can access all the modules, visualize your performance, manage process workflow all from one convenient screen. By keeping you and your staff focused on the performance metrics, you can increase your productivity and save time.
OSP can develop medical billing and coding software to digitize activities that would otherwise have been carried out through paperwork. This type of software also automates most of the repetitive, manual activities to increase the speed and accuracy of the coding process. This leads to fewer errors, which eventually results in faster and more accurate claims being filed. So, reduced paperwork and fewer errors eventually increase efficiency and productivity.
The billing and coding software that we can build makes tracking the status of submitted claims simple and fast. The software sends notifications and alerts in case of denied or rejected claims and also highlights the procedure and deadlines for re-submissions. In addition, our clinical coding solutions also highlight problems in coding and any anomalies in patients’ medical files. As a result, providers can take the necessary steps to avoid denials and rejections.
Medical coder software makes it easy to apply standardized medical codes for filing insurance claims. OSP can develop such software with features for rapid and automated conversion of medical reports into codes and minimizes the chances of mistakes by minimizing the need for human intervention. This goes on to streamline the entire coding process and enables a single person to code the clinical visits of numerous patients.
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We reached out to OSP to provide an estimate on a technology solution we were interested in developing. From the initial conversation, the team was professional, courteous, and thorough. We were able to make a quick decision to move forward with OSP because we were confident that our requirements were accurately captured and the development deliverables and associated costs were clear.
The OSP development team stayed on schedule and within budget throughout the build phase and provided weekly communications to keep our team informed along the way. If we require application development in the future, OSP will be the first call we make.
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The process of medical coding and billing is often tedious. Software platforms for these processes replace pen and paper based activities with digital ones. Additionally, these solutions also introduce automation into the workflows, accelerating them significantly. In short, software for medical billing and coding allow medical staffers to carry out operations with a few clicks and have them verified in a fraction of the time it would take to do it manually.
To sum it up, technology has improved the speed, accuracy, and efficiency of medical coding and billing, benefitting all stakeholders involved.
Medical coding is the translation of medical reports into universal medical alphanumeric codes standardized in the healthcare industry. Coding is used to summarize all the medical services provided to patients for generating claims to be sent to payers for reimbursement to providers. Things like laboratory tests, radiology scans, physician notes, and prescriptions are coded. Every patients’ clinical visit is documented, and then converted into codes.
Medical coding systems are groups of codes corresponding to medical procedures, diagnoses, and other patient relevant information. There are multiple medical coding classification systems –
1. ICD-11 – This is latest revision of the International Classification of Diseases (ICD-11) and replaces the ICD-10 system. It recodifies the categorization of some diseases and includes new codes for some of the latest diagnosis and diseases.
2. ICD – 10 – This is sub-divided into two further coding systems – ICD-10-CM and ICD-10-PCS
3. CPT– The Current Procedural Terminology (CPT) describes the medical procedures that doctors and other providers perform on patients.
4. HCPCS Level II – The Health Common Procedure Coding System Level II is based on the CPT, but is used for non-physician healthcare services. These might include prosthetics and ambulance services.
The process of medical coding is integral for the overall billing operation. A patient’s clinical visit is coded using industry standardized codes for generating claims to be sent to payers. Broadly speaking, medical coding has three main steps –
However, there are additional stages to the process of coding that come before and after these three steps.
Generally, a software for medical billing and coding would cost between $30 and $100 dollars each month per user, not considering additional expenses. Advanced price plans can cost anywhere from $200 to $500 per month.
The cost would also depend on the extent of services offered by providers (since they would use a limited range of codes) and if the software is off-the-shelf or custom developed. While a pre-built software would be cheaper, it would have only the general features typical of coding solutions. On the other hand, custom-built medical coding software would be more expensive, but would also be designed according to specific needs with all the tailored features.
Medical coding is carried out with dedicated software solutions. The latest prevailing coding system is used by a dedicated staff to transcribe medical reports of patients into relevant codes. These codes accurately describe all the billable medical services rendered to patients, for the purposes of generating claims to be sent over to insurance payers.
The insurance payers then analyze the claims to check if everything is done as per policy and will approve if so, or deny if there are discrepancies.
The processes of medical coding and billing are integral to the broader revenue cycle management activities at healthcare organizations.
Medical coding is the process of translating a patient’s clinical visit into standardized alphanumeric codes to generate claims. These codes describe all the services rendered by the provider to the patients, so that they can be billed. There are thousands upon thousands of codes describing an equal number of diseases, tests, scans, procedures, and so forth.
Medical billing is the process of obtaining the coded clinical visit and converting it into a claim to be sent over to payers for reimbursements. In other words, it is nothing but presenting the actual bill for care services.
Software technology for medical coding increases the speed and efficiency of the entire coding process. It replaces manual, paper-based workflows with digital ones and so, things that would otherwise require handling physical documentation can be done with a few clicks on a screen.
Medical coding solutions streamline the process of capturing data about patients’ clinical visit, referencing health records and converting them into relevant codes. This process is automated significantly, with the solution handling repetitive parts of the process. As a result, there are very few chances of errors in medical coding, since human involvement is reduced.
Furthermore, many coding and billing software solutions also include a feature for scrubbing claims. This feature will assess the claims to verify if all codes are proper. So, there are fewer denials from insurers, leading to efficient revenue cycles from payers.
To sum it up, technology streamlines and optimizes the coding processes significantly, enabling hospitals and clinics to boost productivity.
