Computer Assisted Coding

Computer Assisted Coding: Evolving Tool for Health Information Management

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Computer assisted coding software are used to improve maximize the revenue of organisation by reducing coding errors and maximizing claims reimbursement cycle. Some commonly used computer assisted coding software includes standalone and integrated software. Standalone software is used only for encoding and integrated software is integrated with EHR/EMR, encoder system, voice/text/speech recognition software, CDI, transcription system, and other HIM applications.

The rising demand for CAC solutions, the growing need within the global healthcare system to curtail increasing healthcare costs, improve coding accuracy, and streamline the revenue cycle management procedures.

Growth of the market can be attributed to the transition to ICD-10 coding standards from ICD-9 in North America. However, high implementation and maintenance expenses for computer-assisted coding and lack of on-site CAC support and in-house CAC domain knowledge are likely to hinder the growth of the computer-assisted coding market to some extent.

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Applications such as automated computer-assisted encoding, management reporting & analytics, and clinical coding auditing drive the growth of computer assisted coding market.

Automated Computer-assisted Encoding

Automated computer-assisted encoding is one of those applications enables compliance with regulatory standards for clinical coding, thus ensuring that the information exchanged between different healthcare organizations is consistent, comparable, and meaningful.

Management Reporting & Analytics

The healthcare IT industry is facing challenges to make data accessible, sharable, and actionable. The management reporting and analytics modules of computer-assisted coding are designed to enable coding and revenue managers to monitor and track coding processes throughout the workflow. These tools help in tracking the various stages of coding procedures such as case assignment, recording the point and time of modifications to original coding, and the duration for which the chart was open. With analytics tools, coding data can be examined and used more efficiently in making critical decisions.

Clinical Coding Auditing

Clinical coding auditing reduces regulatory compliance risks by identifying potential patterns for fraud and enables healthcare organizations to maximize reimbursement by improving coding accuracy. Clinical coding audits include a statistical audit, subset audit, percentage audit, and a complete audit. They are aimed at providing a more comprehensive overview of the areas of concern using a more extensive data set. The complete clinical code audit uses all relevant data available to ensure a thorough audit. However, there are a number of solutions in the market that provide customizable auditing options, enabling users to define specific parameters for the information to be used. Such solutions help accelerate the auditing process.

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The high implementation and maintenance costs and lack of on-site CAC support and in-house CAC domain knowledge are major factor restraining the growth of the market. The American Health Information Management Association (AHIMA) states that the cost of the hardware, initial licensing fees, ongoing maintenance fees, and the requisite IT support for CAC systems can cross USD 500,000 a year for a small health system (1,000 beds). Even though smaller hospitals generally pay less in licensing fees for the software, the per-chart coding cost is usually higher. Also, services and maintenance, which include software upgradation as per changing user requirements, represent a recurring expenditure for healthcare organizations. This has adversely affecting the affordability of various computer assisted coding solutions for organisations.

Computer Assisted Coding Market

The growth of this region is primarily driven by the escalating demand to reduce the burden of the healthcare systems, curtail healthcare delivery costs, increasing implementation of Healthcare IT solutions, and the various government initiatives for enabling efficient, affordable, and on-time delivery of quality care. As a result, APAC holds a significant share of the overall computer assisted coding market.

Key players in the Computer Assisted Coding Market include 3M Health Information Systems (US), Optum (US), McKesson Corporation (US), Nuance Communications (US), Cerner Corporation (US), Dolbey Systems (US), Precyse Solutions (nThrive) (US), Craneware (UK), Artificial Medical Intelligence (US), and TruCode (US). Other players include Quest Diagnostics (US), Streamline Health Solutions (US), M-scribe Technologies (US), eZDI Inc. (US), Alpha II LLC. (US), ID GmbH & Co. KGaA (Germany), ZyDoc (US), Coding Strategies (US), Patient Code Software (US), and Flash Code (US) among others.

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