Custom Medical Coding Solutions

Medical coding is translating detailed medical reports into a specific type of short code (CPT or CDT codes) recognized throughout the healthcare industry. Medical coding aims to convert complicated healthcare reports into efficient, easy-to-interpret codes to file claims to send to payers. Medical coding software is used to generate codes automatically from clinical reports. It accelerates the entire coding process and uses automation to minimize human intervention, thus minimizing the chances of errors. Software for medical billing and coding helps increase revenues for providers.      

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Automated coding data extraction is the process of abstracting the coded data elements from patient records for a pre-defined user process. This data extraction using medical coding solutions may help in a broad spectrum of functionalities such as outcome measures, performance monitoring, RAC audits, CDC reporting, Joint Commission Core Measures, hospital-acquired conditions, and clinical registries (e.g., cancer, birth).

The structured inputs are required for automated medical coding data extraction. As per the requirement, we can leverage high-quality technology stack in a medical coding system to combine concepts in terms of morphology, syntax, semantics, and real-world knowledge. Through automated data extraction, our medical coding system can perform medical indexing, medical classification, mapping of clinical and non-clinical medical terminologies, quality enhancements for clinical concept extraction, quality Assurance for clinical coding, and more. This can aid in minimizing coding errors, false positives, and false negatives.

With integrated ICD-10 coding data, the encoder software for medical coding can offer automated medical code generation for the healthcare providers. These automated suggestions provide medical codes for review, verification, and application based on the clinical documentation presented by the practitioners. The system has the capability to search for particular diagnostic statements and unique terms and/or abbreviations within the given medical document. Natural language processing (NLP) is applied to a text­ documents that employ computational linguistics and AI to obtain appropriate coding data and terms to convert them into a set of accurate medical codes.

OSP has the potential to design the best medical coding software that can assign medical codes from a pre-defined classification system to the diagnoses generated at the clinic or hospitals. The custom-made encoder software can easily identify ICD-10, CPT and CDT codes, and even nomenclature codes, such as LOINC, RxNorm, and SNOMED-CT for laboratory, pharmaceutical, and clinical documents, respectively.

Automated medical coding is the modern medical coding software that helps in speeding up the coding process workflow and ensure better accuracy. Most medical coding software companies are focusing on the medical coding solution automation to replace the traditional, paper-based coding system. It eliminates manual handoffs and improves staff productivity by driving accurate and efficient coding for the ambulatory health care industry segments.

We can build a made-to-order encoder software for medical coding where each claim to be submitted is thoroughly reviewed and scrubbed. It is checked by payer-specific rules, cross-reviewed for patient and health plan identification and examined to ensure accurate coding. With a simple and intuitive interface and robust reporting functionalities can help you monitor performance towards success.

Hierarchical Condition Category (HCC) coding model was initiated by CMS for risk adjustment and evaluate future health care costs for patients. Due to the shift to the value-based payment models, the HCC coding is highly prevalent. Our HCC risk adjustment coding relies on hospital outpatient, principal hospital inpatient, secondary hospital inpatient, physician, and trained non-physician.

OSP’ custom medical coding solutions can comprehensively assess the current status of HCC capture rates of your healthcare provider organization through smarter claims data analysis and medical record review. This can aid in finding the gaps in optimum HCC capture and can help in improving the capture, medical coding quality, and overall revenue collection through the healthcare payment system. Our medical coding solution incorporates focused chart review, chart audit summary reports, HCC validation through RADV audit, and report of missing/embedded codes.

Today’s healthcare provider organizations and medical practices struggle to ensure a good quality medical coding system that provides complete and accurate documentation and compliant coding process. With highly complex ICD-10 codings, government legislation, and regulations, the best medical coding software is in demand. To comply with all the required compliances and reduce claim denials, medical coding solutions should incorporate periodic medical coding and documentation audit module.

OSP can customize automated coding audit module in medical coding software to minimize risk and regulatory exposure and receive appropriate reimbursements. Our coding audit system helps you streamline HIPAA-compliant audit workflow with HIM-level reporting and accuracy scores. The coding auditing will support in ensuring the coder compliance with new regulatory requirements to mitigate risk and implement industry standards and best practices to enhance performance.

A real-time and intuitive medical coding solutions dashboard can promote the qualitative coding, analysis and reporting at a better scale. The process workflow management, performance monitoring, coding audits, HCC coding analysis can be understood and enhanced with an easy-to-use dashboard for encoder software for medical coding.

We simplify the computer-assisted coding process and help you improve your productivity by providing a clear picture of coding performance and accuracy through real-time dashboards. You can access all the modules, visualize your performance, manage process workflow all from one convenient screen. By keeping you and your staff focused on the performance metrics, you can increase your productivity and save time.

Benefits 

OSP can develop medical billing and coding software to digitize activities that would otherwise have been carried out through paperwork. This type of software also automates most of the repetitive, manual activities to increase the speed and accuracy of the coding process. This leads to fewer errors, which eventually results in faster and more accurate claims being filed. So, reduced paperwork and fewer errors eventually increase efficiency and productivity.

The billing and coding software that we can build makes tracking the status of submitted claims simple and fast. The software sends notifications and alerts in case of denied or rejected claims and also highlights the procedure and deadlines for re-submissions. In addition, our clinical coding solutions also highlight problems in coding and any anomalies in patients’ medical files. As a result, providers can take the necessary steps to avoid denials and rejections.

Medical coder software makes it easy to apply standardized medical codes for filing insurance claims. OSP can develop such software with features for rapid and automated conversion of medical reports into codes and minimizes the chances of mistakes by minimizing the need for human intervention. This goes on to streamline the entire coding process and enables a single person to code the clinical visits of numerous patients.

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