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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medical coding
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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RCM: Average Length of Clinical Notes Continues to Increase
What You Should Know:
In 2021, the Centers for Medicare and Medicaid Services (CMS) implemented changes to evaluation and management (E/M) CPT billing codes aimed to reduce the administrative documentation burden on providers.Epic Research just came out with a new study that shows the average length of clinical notes has continued to increase over the last three years.
Understanding Why Clinical Notes Remain ‘Bloated’
The study evaluated 1.7 billion clinical notes written by 166,318
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6 Ways Health Payors Can Leverage Intelligent Document Processing for Cost Savings
The prevailing global economic conditions are negatively impacting the healthcare industry. Continuing staff shortages, endemic COVID-19, high inflation rates, and supply chain disruptions continue to drive medical costs higher, worsening what is already a persistent challenge for health insurers.
To offset rising healthcare costs, health insurance payors are challenged to find ways to contain their own costs by streamlining their processes and tightening their belts, which invariably
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Medical Coding Market to Reach $15.3B by 2033, Report Finds
What You Should Know:
- The medical coding market is estimated to secure a valuation of $ 6.7B in 2023 and is estimated to rise to $15.3B by 2033 at a CAGR of 8.6% during the 2023 to 2033 forecast period, according to a new Future Market Insights report.
- The increasing availability of a large number of medical coding service providers and the rising adoption rate of advanced healthcare solutions like electronic health records (EHRs), revenue cycle management (RCM) software, and mobile
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5 AI-Driven Healthcare Trends and Solutions in 2023
Enterprise-level healthcare is a massive business sector with seemingly infinite moving parts. With patients’ lives at stake, liability is huge, leaving little room for error. Yet human error is common in healthcare, and minor mistakes can cost millions in legal fees and lawsuits, not to mention risks to patient health. Healthcare enterprises are quickly embracing artificial intelligence solutions to mitigate loss, streamline operations, improve efficiency, and enhance customer
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New Medical Billing Codes You Should Know About
Physicians need to keep their billing and coding right to ensure seamless reimbursements from payers. Similarly, they should stay updated with the latest coding changes to keep their revenue cycle intact. In addition, running a successful medical practice is a daunting task as the providers need to stay updated with the industry guidelines. The year 2023 is bringing changes in medical codes to help providers reduce their burden and streamline patient care. So, providers need to stay focused on
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CodaMetrix Raises $55M for AI-Powered, Autonomous Medical Coding
What You Should Know:
- CodaMetrix, an AI technology platform transforming healthcare revenue cycle management, today announced that it closed a $55 million Series A round led by SignalFire. Frist Cressey Ventures (FCV), Martin Ventures, Yale Medicine, University of Colorado Healthcare Innovation Fund, and Mass General Brigham physician organizations also participated in the round.
- The capital injection will accelerate go-to-market with major provider organizations and health systems, as
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If You Are Not Using AI for Medical Coding, You Are Not Doing Your Job
A quick, efficient, and well-managed revenue cycle creates a solid foundation for a profitable medical organization. That’s why if you’re responsible for ensuring the health of your organization's revenue cycle and you are not using AI for medical coding, you are not doing your job.
Let me explain.
Some RCM professionals may see medical coding as a small portion of the revenue cycle; however, its reach is wide. The quality and accuracy of medical coding can either negatively or
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