Artificial Intelligence Meets Medical Coding

FREMONT, CA: Medical billing and coding is an integral component of healthcare. The medical coding outsourcing market alone is projected to reach16.9 billion dollars by 2021. However, coding accuracy is an ongoing challenge. To maximize efficiency and accuracy of the medical coding process, companies are testing the possibilities of Artificial Intelligence (AI) applications. The current problem is coding accuracy, and AI applications are improving the efficiency of the coding process.

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The emerging technology, Computer-Assisted Coding (CAC), which works on Machine Learning and Natural Language Processing (NLP), is all set to transform the medical coding process. The CAC automatically identifies and extracts information from documents. It also analyzes the documentation and automatically recognizes [vendor_logo_first]relevant medical codes. In addition to processing codes and high volumes of data, AI can also reduce the standard work hours and human errors. AI helps providers address gaps in medical coding information. The AI reviews documentation and then guides the provider to adjust the documentation to ensure it accurately reflects the patient’s condition.

While utilizing AI to catch coding errors would be enough to justify its use, there are several other benefits that come along with it. AI’s potential for identifying false claims or suspect charges is one of the most obvious benefits. With healthcare fraud costing Americans around 68 billion dollars to 230 billion dollars yearly, having AI in place can immediately recognize suspicious activity. Additionally, AI is capable of identifying information that’s not explicitly stated in care providers’ documentation. Even with all of the benefits of accurate coding, doctors still fail to have a complete understanding of medical coding. Fortunately, AI can offer natural language software to apply appropriate codes even when a physician fails to document them thoroughly.

Medical coding is an essential component of how care is delivered and. Inaccuracy is a roadblock that needs to be addressed with the help of advanced technologies such as AI.