Medical coding is a simplified transformation of medical diagnosis, clinical procedures, treatments, and equipment into ICD-10 coding. The medical coding system is nothing but a translation engine that translates the clinical procedures data into pre-defined codes. Medical coding solutions help ensure the medical codes are applied accurately during the medical billing process. Putting the proper medical codes include extracting the data from the documentation, assigning the relevant codes, and creating a claim to be compensated by insurance carriers. OSP’s custom medical coding solutions help you get paid faster by sending accurate insurance claims the first time.
The common bottlenecks which might slow down your business growth
Lack of automated coding with time-consuming and manual coding process.
Multiple coding errors, increasing the claims denial rate and affecting the revenue collection.
Inability to efficiently comply with essential healthcare data compliance like HIPAA and HL7.
Weak medical coding auditing process, affecting the overall coding performance management.
Inability to create structured data inputs required to extract the coding data seamlessly.
Traditional coding systems with outdated coding sets affecting the success of medical billing
Transforming medical coding with computer-assisted coding for accurate and prompt claims processing.
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.
OSP has worked with Stephen to create a mobile health application offering 'Doctor on Demand'. This mhealth solution is based on the Uber model to enhance the availability of health access in the US.
The goal of a healthcare claim management organization in California is to replace paper-based claims processing with an advanced automated patient billing & claims management system. The system required to be used across a broad-spectrum including doctors, nurse practitioners, and payers to manage the dental patient.
The challenge was to bring various individuals involved in the dental claim management process from a community center, dental health providers, medical coder & biller to payer and government under the same roof.
The solution comes with-
A comprehensive web-based claim management solution was customized for FQHCs to reorganize the claim process workflow from dental health providers to government payers.
With granular-level user roles and reimbursement management, the feature-packed platform offers maximum confidential data security controlled by HIPAA regulations.
Using ICD-10 & CDT code, dentists can easily file a claim that decreases the claims denial ratio from billing reviewers and gets paid on the same working day.
A Texas-based mental health center wanted to reinvent the medical billing process and enhance approval rates which were 10% against 100 claims submitted.
It was challenging to manage multiple insurance providers for a large clinic set up for a health specialty that needs flexibility in billing, workflow automation, accurate claim scrubbing, and fill regulatory compliance gap.
The solution comes with-
A web-based claim scrubber to check claim accuracy against hundreds of Healthcare billing and coding requirements. A detailed report can be added to prevent future billing mistakes.
An easy way to enter procedure codes, modifiers, and bundled codes with the ability to create a streamlined list of CPT and ICD-10 codes.
Support legal forms such as HIPAA forms, HCFA-1500, Assignment of Benefits.
Ability to create appeal letters for denials, electronic remittance support for bulk check posting, automatic deposit of reimbursements, and electronic EOB.
A US-based client sought a healthcare software solution to help patients to access remote healthcare without a hassle. The client also wanted to reduce patient follow-up visits, especially for chronic disease patients.
The challenge was to create an EHR-integrated remote care telehealth platform offering practice management, medical appointment scheduling, and a secure data warehouse with a fully-regulated HIPAA & HL7 compliant structure.
The solution comes with-
A web and mobile-based telehealth platform were made for chronic disease management and follow-up visits.
Seamless integration with existing EHRs and practice management system, powered by HIPAA-compliant data transaction.
Embedded solutions for HIPAA-compliant video conferencing, real-time notifications, advanced reporting were provided.
High-touch technical support for both providers and patients offered to make ‘urgent care’ possible & hassle-free for patients anytime, everywhere.
Most medical coding software companies have pre-defined coding workflows that supersede the client's ongoing coding workflows. OSP' medical coding audit software is tailored as per the client's needs that offer customized medical coding workflows to fit the needs of the customer exactly. Our tailored medical coding software can help to streamline the workflow by filling up the gaps in the flow. A customized coding workflow can provide an efficient and consistent process of coding which leads to improved revenue on the backend of the healthcare revenue cycle process.
The medical coding solutions can be customized to offer you the prompt, accurate and efficient claims review before posting. Flagging possible claim denials and rejection can help providers to autocorrect the billing errors, reduce claim denials and get completely reimbursed on time. We tailor medical coding audit software that checks the format of your medical claims for any missing data and verifies it against various payer-specific formatting conditions. A claim review report will notify the providers offering a list of errors and rejections that should be resolved before payment posting.
Apart from improving medical coding workflow and code selection, the regulatory compliant coding is what makes our custom solution among the best medical coding software solutions. Our high-quality medical coding audit software can build a complete suite of customizable pre-billing rules based on claims data, payer contracts, denial details, and most importantly HIPAA-compliance. Regulatory compliant coding can play a vital role in reducing reimbursement delays and audit risks by complying with the pre-defined custom rules of regulatory compliance.
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