CAPC Demo - AGS Health

Navigate CAPC with Ease

Engineered for speed and simplicity, our CAPC module leverages a workflow-oriented interface featuring three key sections—Worklist, Workbench, and Dashboards and Reporting. Let's begin by taking a look at Worklists.

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Coding Worklist

The Coding Worklist interface is divided into three panels—Worklists (left), Case List (middle), and Case Detail (right).

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Worklists Panel

Worklist Buckets allow coders to plan and prioritize their daily caseloads more effectively and efficiently by segmenting cases based on different workflow stages, including New, Assigned, On Hold, Updated, and Completed Cases.

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New Cases

New Cases feature all coding cases that are available for coding. This segment is composed of two subsections based on the availability of documentation. Cases with documentation available will be marked as Ready, while cases lacking documentation will be marked as Not Ready.

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Assigned Cases

Charts assigned to a coder by a supervisor will be listed under Assigned Cases. These cases are further segmented as either In Queue or In Progress based on the current status of the case.

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On Hold Cases

When working cases, coders may need to briefly suspend work to request support from a colleague, initiate a physician query, or seek out missing documentation. The On Hold Cases list allows coders to review all currently suspended cases that are awaiting feedback.

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Updated Cases

When an On Hold case receives an update, coders are automatically notified and the case is transferred to the Updated Cases list. This eliminates the need for manual tracking of pending charts, saving time and maximizing coder utilization.

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Completed Cases

Completed Cases provides a list of finally coded cases segmented into two subcategories—Sent for Review and Sent for Billing. The review workflow allows you to have a second look at a coder's work before it goes to bill.

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Case List Panel

When a user selects a worklist from the Worklists Panel, all cases associated with the specified worklist will appear within the Case List Panel. Here, the coder can easily sort cases based on multiple criteria. They can also view patient demographics for each case.

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Case Detail Panel

Once a case is selected within the Case List Panel, users will see additional information for the case in the Case Detail Panel. This panel allows coders to quickly review detailed demographics, case summaries, event timelines, and more.

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Sorting

This feature allows you to sort the cases by Admit Date, Assigned To, Case Value, Default, Discharge Date, and Last Modified Date.

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Search

The smart Search bar enables users to rapidly locate and review charts based on a variety of keyword criteria, including admit date, physician, discharge date, patient class, service line, and more.

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Saved Searches

Frequently performed search queries can be bookmarked within the Saved Searches utility by simply clicking the star icon located on the right side of the search bar.

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Edit Case

Once a coder has located and selected the appropriate case, they can simply click the Edit Case link within the Case Detail Panel. This will navigate them to the coding Workbench section.

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Workbench

The Workbench interface collects all of the necessary documentation for coding, eliminating the need for multiple application windows and alleviating concerns of missed documentation. Workbench is divided into two panels—Medical Records (left) and Coding Evidence (right).

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Workbench

Similar to the CAC and CDI modules of the AGS AI Platform, CAPC leverages a proprietary natural language understanding (NLU) technology that reviews documentation and suggests codes. All code suggestions are linked to documented evidence contained within the medical record to save time and increase coder productivity.

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Medical Record Panel

The Medical Record Panel displays all documentation and notes related to a patient visit. Users can easily navigate and review one or many documents using the continuous scroll bar utility.

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Coding Highlights

Coding Highlights emphasize key details in the documentation that the system has used to suggest a code. Clicking on a highlighted word or phrase will immediately take the coder to the respective code within the Coding Evidence Panel on the right-hand side of the screen.

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Coding Evidence

The Coding Evidence Panel displays all of the suggested codes. Each code suggestion is tagged with evidence to form an audit trail. By clicking on the evidence, coders are automatically directed to the source information located in the Medical Record Panel.

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Accept/Reject/Modify code

Suggested codes can be easily accepted, rejected, or modified with the simple click of an icon located next to each code.

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Adding a Code

If a code needs to be added, users can leverage the built-in encoder and codebook by simply clicking the Add Code button located at the top of the Coding Evidence Panel. From there, the user simply needs to select the type of code.

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E & M code

Within the Add Code dropdown menu, users can also select E&M for clinical NLP-based E&M code and level suggestions.

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E & M code

Coders and auditors can quickly drill down into suggested E&M codes to verify and understand the rationale for each suggestion.

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Custom Edits Alert

To prevent potential errors, supervisors and health information managers can create Custom Edit Alerts.

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Custom Edits Alert

Custom Edit Alerts are easy to configure and can be created in less than 5 minutes. There are no IT requirements to meet, support tickets required, or waiting periods.

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Adding a Code

Selecting a code is quick and easy. If the user is familiar with the code they wish to add, they can simply input the code and click save. However, if the user is not confident in their ability to recall the correct code, they can simply choose the Open Codebook option to search for the appropriate code.

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Codebook

The embedded Codebook allows users to search for the correct code using either the index or keyword terms. Additional references are also available to ensure accuracy. To add a code from the codebook to the Coding Evidence Panel, users can simply double-click on the code. It's that easy.

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Code Auditing

To ensure codes are accurate and optimized, the CAPC module also provides tools to assist with auditing. To access this feature, we will navigate back to the home page. From the home page, users can simply click on the Coding Cases Dropdown Menu, and select Audit from the list.

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Audit Worklist

Anyone with supervisor access can easily create Audit Worklists in minutes. Audits can be pre-bill, retrospective, or re-audits, and they do not require support tickets or waiting periods.

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Building Audit Worklist

Once the user selects the desired audit type, the next step is to define the criteria for the audit. Out of the box, the system offers multiple pre-configured parameters to choose from, enabling the user to quickly identify a specific population.

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Building Audit Worklist

After the audit criteria are defined, users are presented with the option to audit all encounters or define a specific sample size. Additionally, users can choose to tag audits to a desired Audit Worklist.

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Audit Cases worklists

Much like the Coding Worklist screen, auditors are presented with a similar 3-panel Audit Worklist interface featuring Worklists (left), Case List (middle), and Case Detail (right). Each auditor's Worklists panel is populated with charts based on their assigned Audit Worklists.

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Audit Cases worklists

Clicking Edit Case gives auditors access to the Case Detail panel, where they can continue reviewing charts from where the coder left off. Auditors can access all codes, edit codes, and add comments next to each code for coder education.

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Completing an Audit

Prior to completing an audit on a chart, auditors will be presented with any audit-specific edits configured for them. Upon completing an audit, auditors can enter an overall audit comment for each chart.

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Completing an Audit

When an audit is completed, users are automatically directed back to the Audit Worklist screen where they can continue to work on other charts.

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Audit Report

In the event that an auditor needs to reflect on their work, a detailed Audit Report can be accessed from the Case Summary within the Case Detail panel.

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Audit Report

Audit Reports provide access to a variety of insightful tools, including comparisons between coder and auditor codes, modifications made by the auditor, and any audit findings added by the auditor.

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Feedback Center

To facilitate and enhance collaboration, both coders and auditors can access the Feedback Center located on the right-hand navigation panel.

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Feedback Center

The Feedback Center allows coders to review Audit Reports and any comments submitted by an auditor.

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Dashboard

To support accountability and continuous improvement, coders and auditors have access to individual user performance Dashboards.

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Dashboard

Each user's Dashboard provides access to real-time performance metrics. Dashboards can customized with a variety of key performance indicators based on user needs or interests, including case mix index (CMI), inventory, productivity, and much more.

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