This guide helps health information management (HIM) leaders understand how autonomous medical coding technology integrates with existing workflows and addresses key challenges facing HIM and coding departments today. The following sections outline coding capabilities, workflow considerations, performance metrics, and organizational impacts.
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What are Today's biggest HIM & Coding Challenges?
Burnout & Retention Challenges
- Administrative Burden driven by staffing challenges and increasingly complex regulatory guidelines
- High Turnover costing departments thousands in recruitment and training
Workflow Challenges
- Complex Workflows forcing coders to continuously shift their focus and adapt to different code classification systems
- Resource Management Challenges including training offshore/contracted resources and managing quality and compliance issues
Do Autonomous Coding Solutions Change Your Workflow?
Autonomous coding technology seamlessly integrates with existing healthcare systems to create more efficient and consistent coding processes. Below is an example of how Nym’s engine seamlessly integrates with customer EHRs to accurately assign codes to patient records and send them directly to billing with zero human intervention. Charts that the engine is unable to code (due to missing information, documentation issues, etc.) are routed to coders for manual coding.
Comprehensive Coding Capabilities
- Intelligent Code Assignment – Automatically assigns CPT, ICD-10-CM, and Modifiers
- Comprehensive Coverage – Including Evaluation & Management codes
- Precision & Compliance – Ensuring accurate billing & reimbursement
Built for Any Setting
-
- Inpatient and Outpatient Facility
- Provider-Based Services
- Single Path Workflow
Note: Coding scope and supported code sets may vary by autonomous medical coding vendor
How do Autonomous Coding Solutions Perform Across Different Specialties?
Different medical specialties present unique coding challenges and opportunities for automation based on documentation patterns and case complexity. Understanding specialty-specific automation rates (the percentage of total encounters coded by the autonomous medical coding solution) helps HIM and coding leaders set realistic expectations and identify the highest-impact areas for implementation.
| Specialty |
Typical Automation Rate |
|
Emergency Department
|
60-70%
|
|
Outpatient Surgery
|
50-65%
|
|
Primary Care
|
55-75%
|
|
Radiology
|
70-85%
|
These rate typically increases over time as machine learning algorithms process more data. Autonomous medical coding solutions may route encounters to manual coding teams in certain cases, such as:
- Incomplete or missing documentation in patient records
- Ambiguities in physician notes
- Complex case requirements
Note: Automation metrics represent industry averages and may vary by vendor, implementation approach, and documentation quality.
What are the Proven Benefits for HIM & Coding Teams
Autonomous coding solutions deliver measurable benefits that address the core challenges facing HIM and coding departments today. Real-world implementations demonstrate significant improvements in staff satisfaction, workflow efficiency, and financial performance metrics.
Address Burnout & Retention Challenges
- Eliminate mandatory overtime and paid time off (PTO) restrictions - autonomous coding reduces backlogs, enables flexible scheduling, and improves work-life balance
- Improve staff satisfaction and retention - automated routine coding creates advancement opportunities and reduces turnover-related costs
Real-World Example: After implementing Nym's autonomous medical coding engine for ED facility coding, Inova, a top health system, eliminated all overtime requirements for ED coders, removed PTO limitations, and promoted four ED coders to higher complexity areas. Read the Inova Case Study.
Solve Workflow Challenges
- Streamline coding operations - by automating the coding of routine encounters, autonomous coding solutions create consistent, predictable workflows and eliminate the need for offshore or contract coders
- Improve DNFC (Discharged Not Final Coded) metrics - most autonomous coding solutions can code thousands of charts per hour, a huge gain in processing speed compared to traditional manual coding (anywhere from 10-40 charts per hour per coder) – this improvement in coding turnaround time significantly reduces the volume and age of encounters awaiting coding, accelerating the revenue cycle and improving cash flow
- Reduce coding costs - autonomous coding solutions deliver substantial cost savings through labor arbitrage, typically offering lower cost-per-claim than traditional in-house coding teams or Business Process Outsourcing (BPO) alternatives
Real-World Example: After implementing Nym's autonomous coding engine for ED facility coding, Inova eliminated their need for contract coders, reduced annual ED coding costs by $500K, and reduced the revenue sitting in weekly DNFB by 50%. Read the Inova Case Study.
What are the Key Implementation Success Factors?
Successful implementation of autonomous coding technology requires thoughtful planning and strategic change management to ensure staff adoption and operational success. Following some of the best practices and asking the questions listed below can prove crucial to achieving optimal results with autonomous coding solutions.
Change Management Approach
- Communicate early on that the aim of autonomous coding is the automation of routine cases to reduce backlogs and reduce administrative burdens, not coder replacement
- Involve coders in testing and validation to build trust and ownership
- Create career pathways that leverage coders' expertise for complex cases and auditing
- Share success metrics regularly to build confidence in the technology
- Curate facility-specific guidance to share with automation technologists
Questions to Ask Vendors
- What percentage of encounters can be coded autonomously for our specific specialties?
- How does the system handle edge cases and exceptions?
- What is the accuracy rate compared to expert human coders, and how does the vendor measure accuracy? (Look for 95%+ accuracy)
- How will implementation impact our existing workflows and systems?
- What training and support do you provide during and after implementation?
- How will we work together to automate our facility-specific policies and procedures?
Next Steps: Schedule a discovery call to discuss your specific coding challenges and explore how autonomous coding can transform your department.
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