With all the buzz today over Artificial Intelligence (AI), it’s understandable that the coding community may be confused and fearful about its potential, especially when jobs could be at stake. At Aidéo, a leading provider of medical coding productivity solutions, we’re embracing the coding community, in fact, We Love Coders!  We believe the coding community’s best interests are served through a collaboration between humans and AI, leveraging the technology as a useful tool to help make life better.

“AI is a tool for you,” explains AAPC Fellow and Aideo Director of Coding, Marsha Diamond, CPC, COC, CCS, CPMA, “for use in conjunction with your job, not as a way to do away with it.” Because AI is only as smart as what coders put into it, she notes that AI coding systems, such as Aidéo’s Gemini Platform, are informed and built upon coder expertise. “Collaborating with coders makes our AI stronger and of more value to our coding partners,” she emphasizes, ensuring the accuracy of its output.

AI – Friend or Foe?

Diamond encourages coders to embrace and utilize AI to their advantage. “No one is saying the computer is smarter than you. Rather, it can help you be more productive and efficient,” she explains. For starters, AI can pick up the ball and code routine claims, freeing up time for coders to focus on higher-value work.

“In one company I worked for, we were supposed to do quarterly quality audits on all our coders. However, this mostly went to the wayside because we were too busy and didn’t have the time to do it.  We were also responsible for denials, but these were also difficult to prioritize because we were too busy with everything else.” Working as an “assistant,” Diamond estimates AI could have offloaded approximately 50% of that coding work, which “doesn’t require a lot of additional thought power,” clearing time to work denials, quality issues and other tasks that coders are also expected to do.

“Any coder can do chest and abdomen X-rays or office visits, for example. Let the computer do that while you do the things that require a higher level of expertise and enable you to work at the highest level of your license.” 

 

Alleviating Undue Burdens on Coders

Diamond says AI also shines on regulatory and contract issues. “The industry is more varied than it has ever been before by hospital and healthcare system facility. Every insurance carrier wants their claims coded in a certain way. This can overload coders with remembering all the rules and other information, “ she explains.

Aidéo’s Gemini platform includes a rules-based engine to automate all of this information, either auto-coding or providing prompts for coders to act on. “The system serves as an intelligent repository for all of the information,” Diamond explains, so coders don’t have to use their brainpower to do research. “That’s not really coding, that’s just looking things up,” she adds, which isn’t a good use of a coder’s time.”

In addition to managing regulatory and contract requirements, the Aidéo platform also enables coders to sort providers by location, facility, specialty and other parameters  helping to determine what can and can’t be coded. “That’s the power of the platform – replacing cheat sheets, sticky notes, tribal knowledge and the need for memorization.”

The Power of Collaboration Benefits Coders and Providers

Thanks to these efficiency and productivity improvements, AI directly contributes to the amount of business providers can do without having to increase the number of coders they have on staff. Says Diamond, it is entirely possible for an existing team of coders to do twice as much work if AI is picking up 50% of the routine workload.  Shifting resources to work denials before they age out can also produce additional revenue gains.

The promise of AI in medical coding is realized when you increase throughput while decreasing denials. While providing a significant ROI to the mid-revenue cycle operations center the repeatability of autonomous coding effectively becomes a quality control measure.

She adds that “as long as that engine is running, it will code at the same rate and consistency,” which is something that Medicare, in particular, values. “Medicare expects to see consistency, even if it is consistently wrong. Freeing up time to work denials, fully demonstrates the power of the collaboration. “As a human coder, I have a much better opportunity to go back, isolate the errors, and resubmit the claims when I figure out the code is wrong.”

Imagine the Possibilities

Ultimately, Diamond says AI can and will make life better for coders and coding organizations that embrace it. “Your work will become more consistent; your organization will be more successful because you are more efficient and proficient.  These key success factors are consistent with any organization that is doing medical coding.”

Pairing AI with a consolidated coding platform will also improve coders’ quality of life. “Imagine no more multiple screens and logins or having to remember all those rules by payers and providers. Imagine focusing on fulfilling work and having the time to truly concentrate on the most complex, revenue intensive cases.”

Diamond says AI could also be the ticket for coders looking for their next career opportunity. She encourages coders to “get your foot in the door, be that person at the forefront of your organization that supports implementing it. It’s definitely a career path for the future.”

Want to learn more about using AI to streamline coding and improve coders’ lives? Contact Aidéo here to learn more. And remember, We Love Coders!