HOW A HEALTH BENEFITS ADMINISTRATOR OPTIMISED THEIR MEDICAL CODING PROCESS TO FACILITATE FASTER CLAIMS PROCESSING FOR THEIR CUSTOMERS
The efficiency of ICD coding has begun to receive more attention because of how crucial it is for making clinical and financial decisions. Healthcare ecosystems with better coding quality see many benefits, including more accurate classification and retrieval of medical records, thus enhancing predictability and optimizing costs associated with erroneous coding.
AmyGB worked with a Third Party Health Benefits Administrator with more than 21 years of experience in the healthcare sector, to automate their health claims process so as to provide timely settlement of claims filed by patients.
Typically, ICD coding is performed by a professional coder who follows strict guidelines and chooses the appropriate codes according to a doctor’s diagnosis and the patient’s EMR. This coding process is complex and extremely prone to errors since doctors often use abbreviations in diagnoses, causing ambiguous and imprecise matching to ICD codes. Additionally, many diagnoses don’t match exactly to an ICD code — often, two closely linked diagnoses will be encoded in a single combination ICD code and in some cases, doctors may write one diagnosis for a disease that should correspond to multiple ICD codes. The coding process requires a comprehensive consideration of each patient’s health condition. However, very few medical practitioners are capable of taking over the process since they lack training in professional coding.
In order to solve the industry-wide problem with ICD coding, AmyGB has built a deep learning model that automatically translates doctors’ diagnoses into the correct corresponding ICD codes. Our neural networks automatically distinguish the different types of ICD definitions and written diagnoses and accurately capture hidden semantic information.
- Enhanced speed with 95% reduction in processing time
- 60% reduction on manpower dependence
- 20% higher accuracy than manual intervention
- Improved scale of operations with ability to process more applications in lesser time
- Customer Delight with Instant Approvals & faster claims process
- Reduced operational cost
INDUSTRY USE CASES
Use IDP to enhance efficiencies, higher security and greater control of data.
Focus on improving patient care by better management of physician and operations data.
Move beyond manual processes to save time, avoid costly errors and keep valuable information at your fingertips.
Reduce expenses and time spent on issue resolution by eliminating complex, labour-intensive processes.
Extract business-ready information from non-standard documents to improve shipping visibility without any delays.