Blog|Articles|May 2, 2024

7 ways automated coding can help capture reimbursement

Fact checked by: A.C. Baltz

Automation can play a large role in your coding strategy.

Capturing correct reimbursement is crucial for any physician’s practice. Unfortunately, coding staff shortages, chart backlogs and guideline changes often lead to denied claims and revenue leakage. Although myriad solutions have been developed, only coding automation through artificial intelligence (AI) can truly solve the problem. Here are seven ways this AI technology improves revenue capture. But first, it’s important to understand the core reason that coding is a weight on many practices today.

The key problem in today’s medical coding process

When you think of the core challenges facing coding, many issues come to mind: cost, completion time, the chronic shortage of coders and the administrative strain on your practice. The underlying problem, however, concerns mindset: Practices accept the status quo without realizing there are alternatives. Administrators and physicians traditionally have accepted the “fact” that a heavy coding burden is a necessary chore, even though it’s time-consuming, cumbersome, and often frustrating. The truth is, it can be simple, straightforward, and highly accurate.

The latest coding automation technology, based on deep learning AI, has revolutionized the physician coding process. This statement probably sounds hard to believe. The best way to illustrate the impact of AI coding is to look at how another groundbreaking technology transformed the way we live. It’s a commonplace item you likely have in your home: the washing machine. Though this metaphor may sound a bit unusual, bear with me and you’ll soon see the connection.

Before the washing machine, cleaning clothes could be anything from a half-day to an all-day event. Similar to the time-consuming nature of coding, people simply accepted that this was the way things were. But when the washing machine entered the picture, it caused a complete paradigm shift. Suddenly, a task that took hours upon hours could be completed in 30 to 60 minutes. This radically transformed people’s lives, unlocking more time, energy and focus to complete more important tasks.

Like the washing machine, AI coding automation will save your practice many hours of work every week, freeing time for your physicians and staff to work on higher-value activities. This technology will fundamentally transform the way coding is completed. Don’t be surprised if one day everyone in the health care industry looks back to this era and thinks, “How did we ever work without AI coding?”

Coding automation’s impact on revenue capture

You’ve learned about coding’s key problem. Now, let’s look at the specifics of exactly how AI technology helps your practice. Here are seven ways coding automation improves reimbursement capture.

Another benefit of coding automation: improved patient care

Reimbursement capture isn’t the only way coding automation helps a practice. Improved patient care is an indirect benefit of the technology. Just as the washing machine freed up time for countless Americans in the mid-1900s, AI does the same for physicians today, enabling them to devote more energy and attention to patients. With a reduced administrative burden comes less stress, meaning physicians are less likely to experience burnout. Why does this matter? Patients of burned-out physicians are more likely to receive unnecessary tests, experience physician or nursing mistakes and have an overall lower satisfaction level with a medical facility.

Along these lines, coding automation improves the patient experience. As it speeds up the post-visit process, patients will be able to receive their bills more promptly. Although this may not initially seem like a benefit, from a patient’s perspective, faster billing means they’ll be able to more accurately budget for their health care expenses and be less likely to forget about a bill. Without coding automation and thus a slower billing cycle, patients may be surprised with a legitimate bill they expected to come weeks or even months earlier, leading to frustration with your practice.

In summary, the benefits of AI coding automation are simple: Physicians can focus more on patients, and quality of care improves, as does the patient experience.

Your coding burden can become a thing of the past

Coding has probably been a weight on your practice for as long as you can remember. Hopefully, you’re starting to see that change is possible. AI coding automation can substantially lighten your entire practice’s workload and improve revenue capture. It’s only a matter of time before the technology transforms the entire health care industry. Will you be an early adopter and take advantage of the benefits sooner?

Austin Ward is head of growth at Fathom, the leader in autonomous medical coding. He oversees the company's go-to-market efforts and client analytics. He brings broad experience in health systems, technology, and data science and has worked at BCG, the Bill & Melinda Gates Foundation, and in venture capital. He holds an MBA from Stanford University, an MPA from Harvard University and BAs from the University of Chicago.