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CASE STUDY

Computer-Assisted Coding Decreases Claim Denials by 30 Percent

Richmond University Medical Center (RUMC), a 470+ bed healthcare facility in Staten Island, NY realized a 33% increase in coder productivity with AGS Health's CAC.

38%

decrease in DNFC days.

13%

decrease in complex denials.

30%

decrease in rejected claims.

Challenge

During the spring of 2015, RUMC’s encoder vendor was failing to provide the comprehensive workflow and functionality support necessary for the pending ICD-10 migration, which would go into effect on October 1, 2015. The forecasted productivity losses to coders because of the migration were concerning to RUMC executives as it would negatively impact Discharged Not Final Billed (DNFB) and hospital cash flow. Additionally, RUMC sought to reduce the time coders spent coding cases.

Solution

RUMC engaged AGS Health to assess the situation and provide a configured software solution that met RUMC’s unique workflow requirements. AGS ensured RUMC staff were trained and ready for launch. Coders appreciated AGS meeting enhancement requests, like hotkeys and shortcuts, which further improved efficiency.

"One of the absolute best features in CAC, and I can’t stress this enough, are the real-time reports and dashboards that are at my disposal every day, at any given time. I know RUMC’s CMI and many other productivity and financial metrics."

Liza Simanovskaya - Director for HIM

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