Offeror’s software and services shall: Use Artificial Intelligence (AI) and machine learning (ML) to make accurate code assignments while reducing revenue leakage and denials to promote a clean claims process. Provide accurate and compliant autonomous coding consistently with a high level of confidence by reading structured and unstructured medical documentation and have ability to extract data such as diagnoses procedures, lab data, patient demographics, SDOH, etc. Provide technology that uses clinical intelligence to identify codes (ICD, CPT, modifiers) by applying coding guidelines, payer rules, LCD, NCD, CCI and NCCI edits, medical necessity and other policies that support accurate coding. Uses AMA (American Medical Association) licensed CPT data for higher levels of coding compliance. Quickly adjust to regulatory changes to ensure accurate billing. Have the ability to create custom edits. Have the ability to cover and support the spectrum of HIM coding areas for hospital and professional records on a single platform to include emergency room, outpatient clinic and procedure accounts, day surgery and professional clinic accounts. Please list all record types your Autonomous Coding solution can process accurately.
