Key Takeaway: Healthcare revenue cycle departments are at an increased risk of medical coding backlogs and slower payment cycles as the industry continues to struggle with a shortage of qualified medical coders. Autonomous medical coding provides a solution to these challenges and risks by accurately coding patient encounters in seconds and with zero human intervention, enabling healthcare providers to quickly resolve coding backlogs and accelerate payment cycles moving forward.
The medical coding industry continues to face a significant shortage of qualified medical coders driven by factors such as an aging workforce and reportedly high turnover rates. The American Medical Association estimated a 30% shortage of medical coders in 2023, and recent research projects the shortage to grow by 8% by 2029.
When medical coding teams are understaffed, each medical coder becomes responsible for a higher number of patient encounters. Eventually, the volume of patient encounters exceeds the capacity of the medical coding team and leads to coding backlogs.
Coding backlogs have significant financial repercussions that go beyond the medical coding department. By increasing the time from patient discharge to claim submission (referred to as Discharged Not Final Billed, or “DNFB”), coding backlogs directly increase days in accounts receivable (A/R), one of the most important metrics for revenue cycle management (RCM) leaders. At the healthcare organization level, more days in A/R can result in cash flow challenges, a higher risk of bad debt, and other issues that put the financial viability, and thereby the overall health of the organization, at risk.
The persistent shortage of medical coders has many RCM leaders turning to autonomous medical coding technology, which leverages the latest advancements in AI to assign codes to patient encounters with above-industry standard accuracy rates and zero human intervention. Such solutions enable healthcare organizations to alleviate the burden on medical coders and thereby reduce the risk of backlogs, slow payment cycles, and the associated consequences.
As a leader in autonomous medical coding, Nym has worked with several health systems, hospitals, and provider groups whose primary concerns were coding backlogs and slow payment cycles. The following success stories are high-level overviews of real-world challenges and results from Nym’s customers.
The Challenge: A free-standing emergency medicine group experienced an overwhelming medical coding backlog due to a surge in COVID-19 testing and a shortage of qualified coders, leading to administrative burden, delayed payment cycles, and strain on financial stability.
The Solution: The emergency medicine group deployed Nym’s Autonomous Medical Coding Engine to resolve the coding backlog.
The Impact: Nym’s engine successfully coded ~10,000 charts from the backlog in under an hour, with over 98% coding accuracy and traceable audit trails provided for every code assigned by the engine. This enabled the emergency medicine group to quickly resolve the coding backlog, and due to the success of the project, the partnership was extended to include facility and professional ED coding moving forward.
The Challenge: A hospital was faced with skyrocketing DNFB days and the associated delay in payment cycles when its outsourced offshore coding vendor was forced to pause operations due to a COVID-19 lockdown.
The Solution: The hospital partnered with Nym in order to quickly replace its previous offshore vendor and resume coding operations with fully autonomous medical coding.
The Impact: The implementation of Nym’s Autonomous Medical Coding Engine enabled the hospital to resume coding in the face of unpredictable offshore lockdowns. Additionally, Nym dramatically increased efficiency for the hospital, reducing time in A/R by an average of 3-5 days compared to the previous manual coding process.
The challenges of medical coding backlogs and delayed payment cycles are nothing new, but they have become more pronounced in recent years due mainly to the shortage of qualified medical coders. Autonomous medical coding solutions offer a proven solution by fully automating the coding process with unprecedented speed and accuracy, enabling healthcare providers to easily eliminate coding backlogs, accelerate payment cycles, and improve the overall efficiency of their RCM operations.
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