Claimocity Case Study
Code Assist
Code assist reduces coding time to 2-3 seconds per complex encounter, decreasing stress and improving efficiency while mitigating revenue losses and legal risks.
Summary of Findings
Using code assist during complex coding encounters reduces the time cost of coding to 2-3 seconds (from an average of 1-3 minutes) per encounter used, reducing workload stress levels and enabling a seamless workflow transition into the next encounter. Additionally, since the majority of under and over coding efficiency issues occur during complicated or unclear encounters, by reducing the risk of under or over coding in the keystone gray area encounters (with unclear coding situations) a physician’s overall coding efficiency and benchmarks significantly increase over time, helping to eliminate the revenue losses associated with consistent under coding and legal/financial audit risks associated with consistently over coding.
Participant Details
Specialty: Hospitalist Group (Infectious Disease Practice)
Practice Name: Requested Anonymity
Practice Location: New York
Practice Size: 4 Primary Providers
Primary Case Study Category: Time Efficiency
Secondary Case Study Category: Specialty – Infectious Disease
Study Summary
Code assist is an on-demand toggle that has a positive cascading effect on revenue efficiency by simply passing the gray area coding responsibilities from the busy physicians to award winning coders with decades of experience.
Evaluative Situation
Coding is time consuming and repetitive work – often requiring 20-30 efforts per day at 1-3 minutes per encounter. The process is relatively understood by physicians but periodically creates unclear points. When in doubt doctors tend to play it safe and under code or take chances and over code. Under coding costs hospitalists an average of 30-35k per year, with some of our clients having been as high as 118k in a single year. Over coding creates serious financial and legal risks at a time when the audit focus is shifting from hospitals to practices and providers.
Process
By identifying unclear moments of coding as the choke points for higher efficiency levels (coding efficiency, time efficiency, and revenue efficiency), we were able to develop a solution. That solution is a premium feature known as Code Assist, which is a toggle in the charge capture or billing process. Once toggled on, the doctor simply types in, writes down, or takes a picture of any relevant information and documentation, taking an average of 3-10 seconds, and then moves on. Our experienced coding team then handles the coding for that encounter.
RESULTS
- Code assist saves an average of 1-3 minutes per encounter used.
- Code assist increases coding efficiency over time by eliminating the under and over coding from encounters more likely to result in errors and issues. The exact increase in coding efficiency depends on the specialty, particular physician, and other contextual variables.