Primed for Acceleration

Medical coding is a highly manual, inefficient, and expensive process for health systems.

• ~ 20-25% of all revenue cycle costs are spent on coding.
• Specialized human coders are limited in supply and difficult to hire – about 30% of coding positions remain unfilled.
• Existing coding teams are overwhelmed with demand, resulting in higher denial rates and slower collections.
• Claims data resulting from coding often lacks clinical precision and is unreliable for other clinical needs like population health or research.

U.S. health systems spend ~$9B annually on external mid-cycle RCM vendors to manage and optimize the financial components that occur between the initial patient encounter and final reimbursement.

• Major elements of mid-cycle RCM are encounter management, charge capture, medical coding, clinical documentation improvement (CDI), and denials management – the most cumbersome components being coding and CDI. 
• These processes require coding specialists to sift through vast amounts of clinical notes and data to decide how to code a patient encounter or validate its accuracy. 
• As a result, the revenue cycle process has become a highly inefficient, expensive, and error-prone system that leads to millions of dollars of leakage for many hospitals.

Together with health systems, CodaMetrix performs over 50 million annual outpatient visits with 60,000 physicians across 25 states on a multi-specialty platform achieving clinically valuable coding results.

• Providers experience a 60% reduction in coding costs, a 70% reduction in claims denials, and a 5-week acceleration in time to cash.
• The platform significantly improves coding quality while reducing costs, complexity, and administrative burden.
• CodaMetrix currently maintains several co-development partnerships with leading health systems such as Mass General Brigham, Mayo Clinic, Henry Ford Health System, and more.

This year CodaMetrix announced their Epic Toolbox designation allowing Epic based health systems to seamlessly integrate with their products to drive greater value and cut unnecessary costs.

More at CodaMetrix.com.