Physician Coding – Data Analytics with Artificial Intelligence
One of the big challenges in acquiring physician practices or hospitals merging their physician enterprise is the diligence and ongoing monitoring of physician coding practices. Most organizations will do a sampling of physician coding practices, which leaves a high percentage of physician’s practices that are not fully assessed. Obviously, this can result in significant compliance exposure for over coding or under coding and result in revenue loss when a physician is under coding due to poor documentation. The manual process of auditing physician coding practice results in greater risk for the acquiring physician practices, the merging of hospitals which employ physicians, the PE investment in physician practices and the overall monitoring of coding practices.