Put an End to Backlogs and Coder Shortages in Medical Coding

MediCodio, the most trusted AI-medical coding solution provider eliminates the backlog issues, medical coder shortage problems, and delayed payment issues in the medical coding process.

Want to know how?

In this article, we share a brief case study on how MediCodio helped its clients overcome major issues in the medical coding and RCM process.

What is the hurdle?

The healthcare revenue cycle is facing significant challenges due to a growing shortage of qualified medical coders. As the industry grapples with this workforce shortage, revenue cycle departments are increasingly at risk of experiencing substantial medical coding backlogs and prolonged payment cycles. This shortage disrupts the coding process, which is crucial for accurate billing and timely reimbursement from payers.

Medical coders play a vital role in translating patient care into standardized codes used for billing and insurance claims. With fewer coders available to handle the volume of work, many healthcare organizations are finding it difficult to keep up with the demands of medical coding. This bottleneck not only delays the processing of claims but also leads to an accumulation of backlogs, which can have a cascading effect on the entire revenue cycle. Delays in coding result in slower submission of claims, which, in turn, extends the time it takes for healthcare providers to receive payments.

The American Health Information Management Association (AHIMA) highlights that the shortage of qualified medical coders is exacerbated by the increasing complexity of medical coding systems, such as the transition to ICD-10. This complexity requires a higher level of expertise and ongoing education for coders, further straining the limited workforce. According to a survey by Black Book Market Research, 26% of healthcare providers reported that their medical coding backlog had worsened due to staffing shortages, leading to delayed payments and increased financial pressure on their organizations.

In addition to the backlog, the shortage of coders can lead to errors in coding, which may result in claim denials and the need for rework, further slowing down the payment process. As a result, healthcare providers face increased financial risks, including cash flow disruptions and potential losses in revenue.

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AI-powered Medical Coding Software— The Proven Solution

The existing challenges in the medical coding process have obligated healthcare providers to shift to automated technologies.

These advanced technologies use the power of RPA and LLM to analyze patient charts and assign codes.

The AI-based medical coding application enables healthcare organizations to reduce the burden on medical coders and reduce the risk of backlogs, slow payment cycles, and associated consequences.

As a reliable automated medical coding solution provider, MediCodio has interacted with numerous health systems, hospitals, and provider groups that faced challenges with coding backlogs and slow payment cycles. The success stories provided are summaries of the real-world issues and outcomes experienced by MediCodio’s clients.

?Read More: The Best Medical Coding App Powered by AI

A Case in Study of an Ambulatory Surgery Center: How MediCodio Eliminated 15K Chart Backlog in One Hour

The Challenge:?A renowned Ambulatory Surgery Center experienced an overwhelming medical coding backlog due to a sudden surge in patients and a shortage of qualified coders, leading to administrative burden, delayed payment cycles, and strain on financial stability.

The Solution:?The Ambulatory Surgery Center deployed MediCodio’s Automated Medical Coding Software to address the coding backlog.

The Result:?With MediCodio’s AI engine, the ASC coders were able to successfully clear ~15,000?charts from the backlog in under an hour, with over 85% coding accuracy and traceable audit trails provided for every code assigned by the engine. This enabled the ASC to quickly resolve the coding backlog, and due to the success of the project, the partnership was strengthened even further.

Case Study: How MediCodio Enhanced Revenue for a Community Hospital by Streamlining Coding Processes

The Challenge: A prominent Community Hospital was facing a decline in revenue due to inefficiencies in its RCM and medical coding process. With a large volume of patient encounters daily, the hospital struggled with coding accuracy, leading to frequent claim denials, prolonged reimbursement cycles, and lost revenue opportunities. The hospital's traditional coding methods were unable to keep up with the increasing complexity of medical codes and documentation requirements, causing further financial strain.

The Solution: To tackle this issue, the Community Hospital implemented MediCodio’s Automated Medical Coding Software. The AI-powered solution was integrated seamlessly into their existing systems, providing real-time coding assistance and ensuring accurate code assignment for every patient encounter. The software's robust analytics and reporting features also allowed the hospital's revenue cycle management team to identify and rectify coding errors quickly, reducing the likelihood of claim denials.

The Result: Within just a few weeks of deploying MediCodio’s solution, the Community Hospital saw a significant improvement in its coding accuracy, which jumped to 90%. This increase in accuracy led to a 30% reduction in claim denials and a 20% acceleration in reimbursement cycles. As a result, the hospital experienced a substantial 15% increase in overall revenue. The success of this initiative not only stabilized the hospital's financial performance but also strengthened its confidence in leveraging AI-driven solutions to optimize other areas of their operations.

MediCodio’s Automated Medical Coding Software proved to be a game-changer for the Community Hospital, transforming their coding processes, improving revenue streams, and positioning the hospital for sustained financial health.

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