Autonomous medical coding solutions significantly improve the financial and operational performance of healthcare organizations by reducing coding-related costs, increasing coding speed, ensuring highly accurate, compliant coding, reducing administrative burdens, and enabling seamless scalability.
Autonomous medical coding has been well-received by healthcare organizations, and adoption of the technology continues to increase year over year. While the capabilities of autonomous coding solutions vary, the following specialty areas are supported by at least one vendor: emergency medicine, ancillary services (e.g. radiology) urgent care, outpatient surgery, outpatient visits, and inpatient.
By fully automating the medical coding process, autonomous medical coding solutions deliver unprecedented financial and operational value to healthcare organizations.
Financial Benefits
Reduces Coding-Related Costs: By fully automating coding for a significant volume of patient encounters, autonomous medical coding solutions reduce full-time employee (FTE) costs and other labor-related coding expenses.
Accelerates Payment Cycles: Autonomous medical coding solutions code patient encounters in a matter of seconds, decreasing the risk of high DNFC volume and coding backlogs. Down the line, this translates to decreased days in accounts receivable which in turn reduces the risk of cash flow issues, bad debt, increased interest, and other financial concerns.
Ensures Complaint, High-Quality Coding: Autonomous medical coding solutions are constantly updated to align with the latest coding guidelines from payers and other regulatory organizations, ensuring that providers are appropriately reimbursed for their services while simultaneously reducing the risk of coding-related denials, overcoding, and undercoding. This translates to accurate revenue capture and significant cost-savings as a result of reducing the labor-related resources typically required to rework claims and facilitate audits.
Operational Benefits
Reduces Administrative Burden: By fully automating coding for a significant volume of patient encounters, autonomous medical coding solutions reduce the administrative burdens faced by short-staffed medical coding teams. This translates to a reduced risk of burnout, improved work-life balance, and in many cases, opportunities for medical coders to take on more complex tasks related to revenue integrity, auditing, and other coding-adjacent functions.
Enables Seamless Scalability: Because autonomous medical coding solutions do not require any human intervention for encounters they successfully code, they can easily support significant increases in patient volume driven by seasonal increases and/or company expansion initiatives.
Autonomous medical coding solutions leverage advanced technology to fully automate the coding process. These solutions run in the background, taking a first pass at coding all patient encounters and sending all successfully coded charts to billing with zero human intervention. This is a significant improvement upon other solutions like CAC, which require medical coders to validate the coding output before an encounter can be sent to billing.
While the technology powering autonomous medical coding solutions varies by vendor, most solutions leverage multiple subfields of AI, such as natural language processing, machine learning, and deep learning. These technologies enable autonomous coding solutions to accurately interpret the clinical information in patient medical records and translate that information into appropriate medical codes.
Learn about the innovative technology powering Nym’s Autonomous Medical Coding Solution
The medical coding process has changed very little since its inception over 50 years ago, with many healthcare providers relying almost exclusively on certified medical coders to manually review and assign codes to patient encounters. While encoders and computer-assisted coding (CAC) solutions have emerged to support medical coders, a manual approach to medical coding has become increasingly unsustainable within the past few years as the industry faces a shortage of medical coders and increasingly complex payer coding guidelines and policies.
These industry challenges are driving increased administrative burdens, delayed payment cycles, and compliance concerns that ultimately threaten the financial and operational performance of health systems, hospitals, provider groups, and other healthcare organizations. Add in the fact that healthcare organizations continue to operate on razor-thin margins, it’s no surprise that coding and revenue cycle leaders are in need of a next-generation medical coding solution.
Like most healthcare technology solutions, autonomous medical coding was first developed to support a select few specialty areas. However, the capabilities of autonomous medical coding solutions have increased significantly over the past few years. While the capabilities vary depending on the autonomous coding vendor, it is safe to say that as of mid-2024, the following specialty areas are currently supported by at least one autonomous medical coding vendor:
Autonomous medical coding has been very well-received by health systems, hospitals, and other healthcare organizations, and interest continues to increase. According to a survey by the Healthcare Financial Management Association, 60 percent of healthcare organizations either use autonomous
coding or plan to, with half of the respondents who plan to incorporate the technology intending to adopt
a solution within six to 12 months.
Moving forward, autonomous medical coding vendors will look to expand into additional specialty areas so that more and more healthcare organizations can experience the countless financial and operational benefits of this industry-changing technology.