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Latest CASE STUDIES
By AGS Health
October 19, 2023
Proper reimbursement for medical care optimizes healthcare delivery. Maintaining accurate patient records is essential in a healthcare system that's constantly evolving. Accurate records translate to more informed clinicians and better care. Traditional manual coding processes can be time-consuming, error-prone, and limited by human capacity. Machine learning, along with the emerging technologies involving deep learning and large language models (LLMs), offer tools to empower healthcare providers to achieve better accuracy and efficiency in medical coding.
Machine learning algorithms analyze and learn from vast amounts of data, enabling computers to make predictions, identify patterns, and automate complex tasks. In the context of medical coding, machine learning algorithms are employed to:
Supervised learning is a commonly used machine learning technique in medical coding. It involves training a model with labeled data, where the input is associated with a specific output. This typically consists of feeding the algorithm a dataset of medical records and their corresponding codes in medical coding.
During training, the algorithm learns the patterns and relationships between the provided medical records and their associated codes. Once trained, the model can accurately assign appropriate codes to new, unseen medical records based on the learned patterns. This significantly reduces the potential for human error, enhances accuracy, and ensures consistent coding practices.
Unsupervised learning is another valuable technique that can augment the efficiency of medical coding processes. Unlike supervised learning, unsupervised learning algorithms are provided with unlabeled data, and their goal is to identify patterns and structures within the data without explicit guidance.
In medical coding, unsupervised learning algorithms can analyze vast amounts of unstructured data, such as clinical notes, diagnostic reports, and patient records. By automatically identifying similarities, clusters, and relationships within the data, these algorithms can assist medical coders in grouping related cases together - identifying common coding patterns and suggesting appropriate codes for specific scenarios. This accelerates the coding process, reduces manual effort, and enhances overall efficiency.
Machine learning algorithms excel at processing and analyzing vast volumes of medical data, enabling quick identification of relevant patterns and relationships. This capability empowers medical coders to handle larger workloads efficiently, improving productivity and reducing turnaround times.
Machine learning algorithms reduce the potential for human error, enhancing coding accuracy and consistency. By learning from large and diverse datasets, these algorithms can capture intricate coding nuances, guidelines, and exceptions, ensuring precise code assignment and adherence to regulatory requirements.
Machine learning models can provide real-time feedback to medical coders, suggesting potential code revisions or highlighting ambiguous cases. This iterative learning process helps coders improve their skills, minimizes coding discrepancies, and enhances coded data quality.
Machine learning algorithms excel at uncovering complex relationships and patterns within medical data that might elude human coders. By leveraging these capabilities, healthcare organizations can identify insights and trends that lead to better patient care, resource allocation, and decision-making.
Healthcare organizations can effectively analyze vast amounts of data, automate complex coding tasks, and unlock valuable insights by harnessing the power of supervised and unsupervised learning techniques through a combination of different technologies used in medical coding. The benefits of tools like machine learning, deep learning, and LLMs extend beyond improving reimbursement processes; they include enhanced patient care, streamlined workflows, and optimized resource allocation.
If you are ready to improve accuracy and efficiency in medical coding, AGS is here to help you.
AGS Health is more than a revenue cycle management company–we’re a strategic partner for growth. By blending technologies, services, and expert support, AGS Health partners with leading healthcare organizations across the US to deliver tailored solutions that solve the unique needs and challenges of each provider’s revenue cycle operations. The company leverages the latest advancements in automation, process excellence, security, and problem-solving through the use of technology and analytics–all made possible with college-educated, trained RCM experts. AGS Health employs more than 10,000 team members globally and partners with more than 100 clients across a variety of care settings, specialties, and billing systems.
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