Autonomous inpatient coding. This may sound like a pipe dream for revenue cycle leaders, whose hopes were likely raised and crushed in the early aughts. But it's coming sooner than most think. Why is true inpatient coding automation the "holy grail" – as Kerry Gillespie, a former CFO at Intermountain Health and now an executive consultant at Warbird Consulting Partners, said to me at a Healthcare Financial Management Association roundtable last year? For decades, inpatient services have
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medical coding
HIMSS24: CodaMetrix Secures $40M for AI-Driven Medical Coding Solutions
What You Should Know: - CodaMetrix, a provider of artificial intelligence (AI) solutions for healthcare revenue cycle management, has announced the successful closing of its $40 million Series B funding round led by Transformation Capital with participation from existing investors SignalFire, Series A lead, and Frist Cressey Ventures. - The Series B funding round will fuel further development of CodaMetrix's AI-powered platform, designed to streamline medical coding, improve data quality,
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Maverick AI and ImagineSoftware Partner to Automate Medical Coding with Gen AI
What You Should Know: - Maverick Medical AI ("Maverick"), a provider of an autonomous AI-powered medical coding platform, today announced a strategic partnership with ImagineSoftware, a provider of revenue cycle management (RCM) technology in the United States. - The strategic partnership aims to automate the coding process, maximize revenue recovery, and optimize workflows for healthcare providers nationwide. The Challenge: Manual Coding in a Digital Age The healthcare industry
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Aidéo Technologies, MedEvolve Integrate on AI-Powered Coding & Revenue Cycle Workflow Automation
What You Should Know: - Aidéo Technologies, a leading provider of AI-powered coding workflow tools, and MedEvolve, a data-driven solutions powerhouse, today announced a strategic partnership. - The strategic collaboration will integrate Aidéo's Gemini platform and AutoCode solutions into MedEvolve's award-winning Effective Intelligence suite, streamlining workflows and boosting productivity for healthcare organizations. Streamlining RCM Operations with AI The heart of the partnership
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RadNet Embraces AI-Powered Medical Coding with Maverick Medical AI Partnership
What You Should Know: - Maverick Medical AI, a provider of an innovative and autonomous AI-powered medical coding platform forms a strategic partnership with RadNet, Inc., a national provider of free-standing, fixed-site radiology diagnostic imaging services in the United States. - This groundbreaking partnership will integrate Maverick's Autonomous Medical Coding platform into RadNet's extensive network of imaging centers, paving the way for significant advancements in revenue cycle
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Flywheel’s AI Platform Takes Flight with Microsoft Azure and NVIDIA
What You Should Know: Flywheel, a medical imaging artificial intelligence (AI) development platform, today announced the launch of its software-as-a-service (SaaS) data management solution on Microsoft Azure. This new SaaS offering will provide healthcare organizations with a secure, scalable, and user-friendly platform to manage, curate, and analyze their medical imaging data. Flywheel's SaaS solution is integrated with NVIDIA MONAI, part of the NVIDIA AI Enterprise software platform,
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GE and CodaMetrix Partner to Bolster AI-Powered Automated Coding for Providers
What You Should Know: - CodaMetrix has partnered with GE HealthCare to bring its AI-powered automated coding solution, CMX Automate, to GE HealthCare customers. - This will enable GE HealthCare customers to benefit from CMX Automate's ability to improve coding accuracy, efficiency, and revenue cycle management. CMX Automate is a cloud-based solution that uses machine learning, deep learning, and natural language processing to translate clinical notes into billing and diagnostic codes.
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M&A: AAPC Acquires Semantic Health’s AI-Powered Medical Auditing Solution
What You Should Know: - AAPC, a leading global solutions provider in healthcare revenue cycle management, has acquired Semantic Health, an early-stage healthcare technology company focused on creating AI-powered inpatient medical auditing software for health insurance plans and hospitals. - This acquisition will allow AAPC to offer its members innovative tools to streamline auditing processes, reduce denials, and improve documentation quality. AI-Powered Inpatient Medical
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First CPT Code for AI Prostate Cancer Imaging Issued for Avenda Health
What You Should Know: - Avenda Health's AI mapping tool for prostate cancer, Unfold AI™, has received significant recognition by obtaining a new Category III CPT code in the 2024 Current Procedural Terminology (CPT) code set, signifying its status as a cutting-edge medical technology. - The new Category III CPT code, X237T, outlines the tool's capabilities, describing it as a non-invasive prostate cancer estimation map that is derived from an augmented analysis of image-guided fusion
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Why Avoiding Costly Coding Mistakes Is More Critical Than Ever
In May 2022, a California doctor was sentenced to nearly eight years in prison for his involvement in a $12 million Medicare fraud scheme. His crime: performing unnecessary vein ablation procedures on patients, and using incorrect billing codes to receive larger reimbursements. He received $4.5 million in reimbursements from Medicare over a three-year period. Compared to this example, most instances of “upcoding” and “overcoding” are not as malevolent or expensive. But even an
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