How AI is Becoming a Staple in Medical Coding, Auditing
Summary
These mistakes can be a headache for revenue cycle teams looking to submit clean claims and reduce denials, but also for patients who expect a seamless experience from the clinician’s exam room to the back office. AI-enabled technology can summarize large data sets stemming from hundreds of pages of medical records, which a human would have to parse to code an encounter accurately. “The tool can help summarize and give you a snapshot of what happened through the entirety of that admission by quickly capturing the diagnosis and identifying where in the documentation it came from,” Jimenez elaborates. “So over time, this creates a positive feedback loop that frees up the coder to be able to take on more complex work.” AI cannot work in a black box in order to successfully aid medical billing and coding, Jimenez stresses. However, organizations need to ensure they are digitally mature — meaning they aren’t on pen and paper — and have change management in place to leverage AI-enabled coding and auditing technology, Sahar underscores.