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.

Population Health, Readmission Reduction, Coordination of Care

Reducing readmission rates is a major focus for hospitals across the country. This solution can be a great tool for managing population health with the critical clinical data that allows for interventional analytics versus retrospective analytics. It is critical for health systems to manage their post-acute provider network and ensure that they are aligned with the broader population health strategies. Managing the acute and post-acute markets will be critical in improving and coordinating care, reducing readmissions, and reducing overall cost.

Clinical Risk Management

Healthcare organizations are increasingly focused on Patient-Centered Clinical Risk Management Solution; and the value-impact it would have on your hospital, physicians and the patients/population that you collectively serve. In addition, this solution significantly increases the revenues for both your hospital and physicians (averaging $120,000+ per physician per year); it also fosters enhanced quality of care and care outcomes for your patients/populations served!

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