Healthcarercm

The role of technology continues to be critical for healthcare organizations seeking to enhance financial performance while maintaining a high-quality patient experience. The application of   artificial intelligence (AI) and automation technologies   in revenue cycle management (RCM) has reached an inflection point. These advancements are poised to meaningfully change how healthcare organizations manage their billing processes, reduce errors, and subsequently enhance their overall financial performance. The Rise of AI and Automation Historically, healthcare organizations have utilized simple rules-based workflows, surface automation, and basic reporting dashboards to streamline billing processes. However, the emergence of technologies such as generative AI (Gen AI) and the emergence of large language models (LLMs) has opened new avenues for optimizing RCM. The adoption of these technologies opens up opportunities to automate various stages of the revenue cycle, from patient sc...

  The adoption of technology has been a critical driver of change in health information management (HIM) and in the evolution of medical coding technology over the past decade. Healthcare coding has seen a shift from manual, paper-based processes to automated, software-driven systems, enhancing the efficiency, accuracy, and quality of healthcare documentation and billing. This journey towards automation began with the introduction of Electronic Health Records (EHRs) and has been marked by the adoption of  artificial intelligence (AI)  solutions that include  Computer-Assisted Coding (CAC) software  , the integration of  Clinical Documentation Improvement (CDI) software  , and  analytics . Impact of Technology on Medical Coding By providing a digital version of a patient’s medical history, EHRs laid the foundation for the development and refinement of medical coding software, which has enabled more efficient and accurate processing of medical infor...

  Auditing is a crucial component of governance and quality control. When ICD-10  (International Classification of Disease, 10th version) was implemented, numerous healthcare organizations adopted new electronic health record (EHR) technology. It provided record-keeping in considerable detail, outlining  more than 71,000 procedure codes  compared to just over 3,800 in ICD-9. The eleventh revision contains around 17,000 unique codes, and more than 120,000 codable terms – adding to the complexity of coding. Healthcare providers would do well to implement technologies powered by artificial intelligence (AI) and natural language processing (NLP) to make the most of this complex coding system. Leveraging technology can result in fewer billing and data errors. The Growing Need for Audits Clinical documentation improvement (CDI)  is implemented and enhanced with the help of findings from  medical coding audits . Auditing CDI teams can optimize diagnosis-related gr...