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How Exdionca solves the coding crunch for Texas Urgent Care Clinics

The importance of medical coding in healthcare

Medical coding has now undoubtedly become an integral part of healthcare. The medical billing outsourcing market alone has been projected to reach $23.1 billion by 2027. However, there has been an acute shortage of coders to keep up with this demand in Urgent Care Clinics (UCCs).

Even though medical billing has been an essential part of reimbursement in healthcare for decades, medical coders used to either draft their documents by hand or use a typewriter. Not only was this manual process very time-consuming, it was leading to inaccuracies and other medical errors.

Shortage of medical coders

Trained medical coders are in high demand in the healthcare industry, and this demand is expected to grow manifold, according to recent reports from the U.S. Bureau of Labor Statistics. The pandemic has only accelerated this demand.

However, UCCs are facing a severe shortage of trained coders, and this is putting additional pressure on the coders already working in these clinics. A heavy workload and dealing with a vast number of codes on a regular basis will only increase the scope of human errors. Under coding or over coding will lead to inaccuracies in revenue and severely impact the revenue integrity of UCCs in the long run.

CareXpress, a chain of five urgent care clinics owned by Family Medicine Centers located in and around Amarillo, Texas may have missed out on billing for procedures that were conducted by its medical staff. “There was a good bit of revenue that was being left on the table,” said CareXpress Chief Financial Officer Trent Limb. That issue was being further exacerbated by the COVID-19 pandemic. “We needed to look for a solution to deal with the volume of coding we needed to do just to keep up with billing,” Limb said.

Source: HeathTechHotSpot

Medical coding and billing is one of the most complicated aspects of running a UCC. With thousands of possible codes for diagnoses and procedures, and multiple payers, the ability to have efficient billing is a real challenge. There isn’t a one size fits all solution.

How AI can resolve these challenges

The advent of AI-driven coding has helped significantly improve accuracy, eliminate errors and automate many time-consuming medical and billing tasks, allowing employees to focus on other key strategic objectives that enhance UCC revenue. They also integrate into billing workflows and prioritize the work queue for resubmitting denied claims.

This helps reduce costs and increase patient satisfaction.  A recent study on AI-driven coding found that it helped increase coder productivity in UCCs by as much as 20 to 40%.

Exdion Health uses AI-driven coding to analyze medical record documents and assigns ICD-10-CM and CPT codes to them. These platforms automatically generate codes based on specific terms and phrases analyzed directly from the clinical documentation using NLP. This not only saves time and boosts productivity, but also minimizes human error during data transfer.

Increased coding accuracy and productivity with Exdion Health

A number of healthcare providers have begun seeking out partners to help with medical billing as it allows them to focus more on their top priority, patient care. Partners such as Exdion Health are helping improve accuracy and automating many time-consuming medical and billing tasks, allowing employees to focus on other strategic objectives that enhance UCC revenue.

A recent study on AI-driven coding found that it effectively helped increase coder productivity in UCCs by 20 to 40%.

Revenue integrity

Around a decade ago, not too many hospital administrators were listing revenue integrity as a major organizational priority. The concept of revenue integrity has become more important than ever now, with a quarter of CFOs naming it as their top priority.

Here’s a quick look at how Exdion Health enhanced revenue integrity for Family Medicine Centers. In mid 2020, Family Medicine Centers contracted with Exdion Health. The company quickly began analyzing the coding practices of the CareXpress centers. Exdion Health successfully pinpointed numerous areas where revenue opportunities for UCCs had been overlooked. It then concluded that 18% of all of CareXpress’ patient encounters were being under-coded. These adjustments translated to a 40% increase in revenue from more accurate Evaluation and Management (E&M) coding alone.

Manage your revenue cycle with exdionhealth

Exdion’s Revenue Cycle Management solutions help capture revenue comprehensively. Our solutions enable UCCs to collect healthcare payments, helping them to become more profitable.

Smart medical coding solutions such as Exdion Health can enable faster turnaround times, efficiency, cost-effectiveness while boosting revenues.

Get in touch with us to learn more about Smart Coding and Exdion’s Revenue Cycle Management solutions.

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