VerdureRCM

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Human-centered AI in Healthcare

Autonomous Medical Coding

Revolutionizing Medical Coding with AI-Driven Accuracy and Efficiency
Autonomous Coding
With complex coding standards, manual coding is slow and error-prone, causing claim denials. Autonomous medical coding uses Next-Gen AI in Healthcare to interpret records and auto-assign accurate codes, boosting efficiency and finances.

Autonomous medical coding leverages advanced AI in Healthcare and intelligent AI Agents to validate document completeness, automate coding, reduce errors, speed up claims, and increase reimbursement. Accurate coding is key to a healthy revenue cycle, affecting reimbursement, compliance, and operations.

Challenges in
Traditional Coding

Coding Errors

Changing coding guidelines, complexity, and human coders lead to coding errors, thus resulting in inaccuracies for billing,

Delayed Reimbursement

Errors in coding or missing codes can slow down claim processing, delaying payments from payers.

Technology Choice

Using the wrong technology leads to not only inaccuracies, but also wasting resources thus delaying claim processing.

Compliance Risk

Inaccurate coding can expose healthcare organizations to audits and penalties for non-compliance with regulatory standards.

Our Solution : Autonomous Medical Coding

Our Autonomous medical coding solution, powered by an AI Agent, transforms coding workflow by automating code assignment using NLP, rules engine, and GenAI with advanced AI. This AI Agent-driven platform reads clinical data, extracts relevant information, and assigns the most accurate codes, ensuring precision and regulatory compliance.

Key Features

AI-Powered Accuracy

250K man years of expertise led us to using a combination of NLP, rules engine, Gen AI, and AI Agents to assign the right codes to every chart.

Humans in the loop

With confidence scores given by the platform, humans can get involved whenever the score is below a certain point.

Continuous Learning

The system is ever learning, with every chart it processes, and every change that a human in the loop recommends.

Real-Time Coding

Every chart is processed in real time, as soon as it is available, thus reducing the time between encounters and claim submission.

Compliance Safeguards

Built-in compliance checks and audit trails ensures that all codes meet regulatory requirements, reducing the risk of penalties.

EHR and PMS Integration

Integrates with Electronic Health Record (EHR) and Practice Management Systems (PMS) for streamlined workflows.

Key Benefits

Ensure Compliance

AI-driven coding solutions help ensure adherence to evolving coding standards and payer-specific regulations, minimizing compliance risks.

Boost Coding Accuracy

Significantly reduce coding errors and improve first-pass claim acceptance rates, leading to fewer denials and rework.

Faster Claim Submission

With up to 97% accuracy, reduce coding errors and improve automated coding accelerating the process, enabling quicker submission of claims and faster reimbursement cycles.

Enhance Productivity

Free up your coding staff from repetitive tasks and allow them to focus on more complex cases and reviews.

Reduction in Denials

Autonomous coding engine together with human in the loop have the ability to reduce denials due to coding by up to 80%.