The Coding Analyzer provides empirical (statistically based) risks and perspectives on related conditions, drugs, tests, and other factors. This provides a holistic perspective for both clinical and billing services.
The Coding Analyzer:
• Mines both structured and unstructured data.
• Uses NLP and machine learning to gain insights from data.
• Provides collaboration tools between providers and billers.
The solution helps improve operational efficiency by:
• Using advanced NLP algorithms to convert clinical notes into the relevant ICD codes.
• Allowing providers and payers to be reimbursed based on health status or “actuarial risk” of a patient population. It is designed to pay health plans more precisely for the anticipated health costs of a patient population by adjusting payments based on demographics and health status. These attributes are used to generate a risk score - a measure of a patient’s cost to a plan.