NLP-Targeted Second Level Coding Review
Artificial Intelligence (AI) in healthcare is critical, especially in risk assessment. It offers many benefits over traditional analytics. Artificial intelligence and natural language processing (NLP) provide more precise and accurate data which ultimately may drive better patient outcomes.
This type of advanced technology in healthcare allows medical experts to focus less on information search and entry and more on patient care.
Is 95% Coding Accuracy Good Enough?
With increasing financial pressures and compliance audits from OIG and CMS, even health plans with 95-98% coding accuracy may be putting themselves at risk. In an era of uncertainty, health systems and healthcare providers are exploring technologies to decode medical records and deliver real-time insights to improve the patient experience. And this is where AI in healthcare comes in.
Natural language processing can support clinical decision-making for providers looking for point-of-care solutions that simplify complex patient information. When it comes to coding accuracy, NLP and machine learning can be used to automatically extract risk factors associated with a medical record and help prioritize the most impactful add and delete codes.
Like any technology, NLP tools have their advantages and differences, so it is crucial to understand the challenges of integrating NLP technologies into a clinical care program. Many NLP applications intend to order unstructured data, but many still fall short.
Limitations of Natural Language Processing (NLP) in Healthcare:
Natural language Processing (NLP) has some limitations in healthcare, and they include:
Artificial Intelligence Meets Human Expertise
An effective NLP tool for second-level coding review combines targeted machine learning capabilities with the power of genuine human coders. Episource has developed a proprietary AI smart engine, trained by the industry’s most extensive bench of full-time coders who code over 14 million charts annually.
Now, what does the “AI in healthcare” movement mean? Healthcare providers and health systems can ensure complete coding accuracy and compliance—all in a single SaaS platform.
EpiFinalCheck by Episource combines the power of best-in-class NLP technology with expert HCC coders to ensure an accurate and cost-effective review of medical records.