Computer Assisted Coding Of Medical Information

Market Opportunities, Strategies, and Forecasts 2007 to 2013

Publication Date	September 2007
Publisher	Wintergreen Research
Product Type	Report
Pages	246
ISBN Number	not applicable
Product Code	WIN00004

Price

£1,715.00
approximately: $3,204 | €2,175

PDF

Order above formats by FAX

Summary

The number of procedures that use computer assisted coding is set to increase rapidly as the technology becomes more accurate. The trials have been completed successfully. The systems automate a tedious process and create efficient operation in the hospital and physician office environment. In this manner the automation that has been used by banks and manufacturing operations for years is moving to healthcare.

Whereas the healthcare systems have struggled with a payment and collections system that takes 30% of revenue, the banking and financial services industry has been able to run with automated billing systems that take 3% of revenue. As these economies of scale and technology are adapted to the healthcare delivery organizations through computer assisted coding, the most efficient organizations will acquire the less efficient ones.

Computer assisted coding fits seamlessly into a healthcare work flow. An unstructured digitized text from any source. Input can come from transcription services, voice recognition output, and typed note. No templates are needed. Computer assisted coding structures the note and applies appropriate codes. Computer assisted coding checks 100% of the notes and sends information to the billing system or sends notes to auditors for further review. Studies have documented the issues with E&M coding. Over-coding can lead to increased institutional risk. The result is frequent under-coding and lost revenue.

Manual coding processes are tedious and time consuming. After a patient is discharged, a clerk would physically retrieve the medical documents and pass it to a health records analyst who would extract the appropriate information for the billing system. Then the medical record would be passed onto a coder who would write the codes onto a paper face sheet. Next the face sheet would get passed to a data entry operator who would again access the billing system and enter the coding information into the account for final billing.

Hybrid Technology

Computer assisted coding is set to evolve a hybrid technology where the physician develops natural language descriptions of patient conditions that are combined with a set of scales to evaluate patient condition in a more methodical and measurable manner. Just as patients are asked to measure pain on a scale of one to ten, so also physicians will measure patient condition as it relates to a relative scale.

The scale will not be universal, but rather, specific to the physician. The scale will be relative to a physician own experience. In this manner, the expertise of the physician will carry over from one patient to another.

The physician will develop techniques for describing patient condition that are in natural language, then these will be adapted to a coding scale that the physician has control of as well as the natural language coding software.

Computer Assisted Coding Engine

Computer assisted coding applications depend on the development of production quality natural language processing (NLP)-based computer assisted coding applications. This requires a process-driven approach to software development and quality assurance. A well-defined software engineering process consists of requirements analysis, preliminary design, detailed design, implementation, unit testing, system testing and deployment.

NLP complex technology defines the key features of a computer assisted coding (CAC) application.

Focus On Reducing Overpayments

The centers for Medicare and Medicaid services (CMS) is focused on reducing overpayments attributable to claims that do not meet medical necessity requirements. Compounding the situation, CMS rules and policies are updated and are interpreted differently from a fiscal intermediary (FI). A fiscal intermediary may cover multiple states with the same edits. Coding professionals are being asked post-service to help correct claims that were rejected because of medical necessity errors.

If medical necessity validation problems are not identified until a significant number of claims has been rejected, an organization may face not only substantial financial and compliance risks. The costly losses of efficiency are incurred by reworking and resubmitting rejected claims.

The number of hospitals has been steadily declining for 20 years in the U.S. Going forward, the IT department will rule the hospital and the physician office. Just as Kaiser has moved to become a major player in the US health care delivery system, so also any organization will have to master IT, just as Kaiser has with the help of IBM.

The number of patients and procedures is growing as health care delivery is evolved in a more sophisticated manner. In the US, the number of procedures is anticipated to increase rapidly as the population bulge from the baby boomers who are relatively well off creates demand for better healthcare delivery.

Worldwide, the markets are anticipated to grow from $44.8 million in 2006 to $2.3 billion in 2013. The markets are primarily U.S. markets because of the primary role that insurance plays in the health care delivery system. Worldwide markets start to grow as more hospitals and physician offices seek to get control of systems costs and introduce automated process systems

Content

Computer Assisted Coding Of Medical Information Executive Summary
- Hybrid Technology
- Computer Assisted Coding Engine
- Computer Assisted Coding Of Medical Information Market Driving Forces
- Natural Language Computer Assisted Coding Medical Information Solutions
- Natural Language Coding Solutions
- Natural Language Computer Assisted Coding Market Shares
- Worldwide, Computer Assisted Coding Market Forecasts
- Number Of Procedures
- Focus On Reducing Overpayments
1. Computer Assisted Coding Of Medical Information Market Description And Market Dynamics
- 1.1 Healthcare Industry Largest Industry In The United States
- 1.1.1 Building A Safer Health System
- 1.1.2 Facilitating The Use Of Technology In The Healthcare Industry
- 1.1.3 Medicare Prescription Drug Improvement And Modernization Act
- 1.2 Medical Necessity And Medical Necessity Errors
- 1.3 Electronic Coding Technologies
- 1.3.1 Electronic Coding Integrated Database
- 1.4 Natural Language Solutions
- 1.4.1 State Of Language Technology Evaluation
- 1.5 Computerized Workflow System
- 1.5.1 Confidence Assessment Module
- 1.5.2 Researching Electronic Coding Products:
2. Computer Assisted Coding Of Medical Information Market Shares And Market Forecasts
- 2.1 Computer Assisted Coding Of Medical Information Market Driving Forces
- 2.1.1 Natural Language Computer Assisted Coding Medical Information Solutions
- 2.1.2 Natural Language Coding Solutions
- 2.1.3 Natural Language Computer Assisted Coding Market Shares
- 2.1.4 Lingologix
- 2.1.5 A-Life Medical
- 2.1.6 Coderyte
- 2.1.7 Platocode Benefits
- 2.2 Worldwide, Number Of Patients And Procedures
- 2.2.1 Worldwide, Computer Assisted Coding Market Forecasts
- 2.3 U.S., Number Of Patients And Procedures
- 2.3.1 U.S. Computer Assisted Coding Market Forecasts
- 2.4 Number Of U.S. Community Hospitals
- 2.4.1 Physician Coding Analysis
- 2.5 Electronic Coding For Physician Practices
- 2.5.1 A-Life Medical Fusion3 Advanced Practice Management System
- 2.5.2 3m Merging Quality With Reimbursement
- 2.6 Claims Scrubbers
- 2.6.1 3m Apr Drg Software
- 2.6.2 Codecorrect Capture Revenue And Maintain Compliance
- 2.6.3 Ingenix Rules Creation Manager
- 2.7 Drg/Apc Groupers
- 2.8 Medical Necessity/Correct Coding Tools
- 2.8.1 3m Health Data Management System
- 2.9 Physician Electronic Medical Record (Emr) Systems
- 2.9.1 Physician Electronic Medical Record (Emr) Markets
- 2.9.2 Inpatient Procedures
- 2.10 Computer Assisted Coding Regional Analysis
3. Computer Assisted Coding Of Medical Information Products
- 3.1 Natural Language Solutions Computer Assisted Coding Of Medical Information
- 3.2 A-Life Medical Actus(Tm) Application Suite
- 3.2.1 A-Life Medical Fusion Advanced Practice Management System Combining Nlp Coding, Billing, And Document Management
- 3.2.2 A-Life Medical Products
- 3.3 Coderyte
- 3.3.1 Coderyte Data Mining Technology
- 3.3.2 Coderyte Systems For Overcoming Documentation Shortfalls
- 3.3.3 Coderyte Web-Based Coding Software Return On Investment
- 3.3.4 Coderyte Coding Software Functions
- 3.3.5 Coderyte Computer-Assisted Coding Solutions Targeted To Specialty Areas
- 3.3.6 Coderyte Codeassist Functions
- 3.3.7 Coderyte Codecomplete Business Process Management
- 3.4 Lingologix Gocode
- 3.4.1 Lingologox Automated Coding
- 3.4.2 Lingologox Gocode Computer Assisted Coding Products For The Healthcare Industry
- 3.5 Platocode Solution
- 3.5.1 Platocode Solution For Ambulatory Surgery
- 3.5.2 Platocode Api
- 3.5.3 Communication Between 3rd-Party Applications And A Platocode Server
- 3.6 Language And Computing: Ontology Assisted Solutions
- 3.6.1 Language And Computing Ontoloy Assisted Coding And Its Benefit
- 3.6.2 Language And Computing Ontoloy Automated Coding
- 3.6.3 Language And Computing -- Ontology Assisted Natural Language Processing
- 3.6.4 Language And Computing Natural Language Understanding
- 3.6.5 Language And Computing Mapping And Modeling Disparate Controlled Medical Vocabularies (Cmvs)
- 3.7 Artificial Medical Intelligence
- 3.7.1 Artificial Medical Intelligence (Ami) Emscribe Dx
- 3.8 Electronic Coding For Physician Practices
- 3.8.1 A-Life Medical Fusion3 Advanced Practice Management System
- 3.8.2 3m
- 3.8.3 3m Merging Quality With Reimbursement
- 3.8.4 3m Apr Drg Software
- 3.8.5 3 M Classification System For Patients
- 3.8.6 3m Apr Drg Software
- 3.8.7 3m Apr Drg Software Features: Versions 20 And 24
- 3.8.8 Codecorrrect 3-57 3.8.9 Codecorrrect Capture Revenue And Maintain Compliance
- 3.8.10 Codecorrect Knowledge
- 3.8.11 Codecorrect Medical Necessity Verification And Apc Performance Tools
- 3.8.12 Ingenix
- 3.8.13 Ingenix Cpt Codes
- 3.8.14 Ingenix Medicare Fee Schedule
- 3.8.15 Quadramed
- 3.9 Claims Scrubbers
- 3.9.1 Ingenix
- 3.9.2 Ingenix Claims Editing System
- 3.9.3 Ingenix Rules Creation Manager
- 3.9.4 3m Claim Scrubber
- 3.9.5 3m Edit Engine
- 3.9.6 3m Apcfinder Software
- 3.9.7 3m Health Information Systems Adds Medical Necessity Validation To Your Coding Workflow
- 3.9.8 Ge (Tes - Transaction Editing System)
- 3.9.9 Mckesson Horizon Practice Plus
- 3.9.10 Mckesson Horizonwp Physician Portal
- 3.9.11 Craneware
- 3.9.12 Craneware Software
- 3.9.13 Athenahealth Medical Group Office Automation Subscription Services
- 3.9.14 Athenaenterprisesm
- 3.10 Drg/Apc Groupers
- 3.10.1 3m
- 3.10.2 Ge Centricity Physician Office Pm
- 3.10.3 Epiccare Mobilemeds
- 3.10.4 Cerner Physician Large Group / Enterprise
- 3.10.5 Siemens Unity Financials Registration And Billing Applications
- 3.10.6 Quadramed Physician Solutions
- 3.11 Medical Necessity/Correct Coding Tools
- 3.11.1 3m Health Data Management System (Info-X)
- 3.11.2 Mckesson
- 3.11.3 Mckesson Horizon Practice Imaging
- 3.12 Physician Electronic Medical Record (Emr) Systems
- 3.12.1 Nextgen Emr Physician Practice Electronic Medical Records System
- 3.12.2 Misys Mobile Practice Management
- 3.12.3 Meditech & Lss Medical And Practice Management (Mpm) Suite
- 3.12.4 Mds Medical / Allscripts Electronic Health Records Software
- 3.12.5 Mds Medical Touchchart Rx+ Electronic Prescriptions Software
- 3.12.6 Mds Medical / Allscripts Touchchart Emr Software
- 3.12.7 Ge (Centricity) 3-113 3.12.8 Mckesson Horizonwp Physician Portal Modules
- 3.13 High-Performance Search & Match Software
- 3.13.1 Wcc
4. Computer Assisted Coding Of Medical Information Technology
- 4.1 Hybrid Technology
- 4.1.1 Computer Assisted Coding Engine
- 4.2 Lingologix Gocode Technology
- 4.2.1 Accuracy And Specificity Of Retrieval
- 4.2.2 Lingo Engine Natural Language Programming (Nlp) Vocabulary Processor
- 4.2.3 Robust Underlying Terminological Model And A Component Architecture
- 4.3 Tessi (Terminology Supported Semantic Indexing)
- 4.3.1 L&c's Linkbase Medical Ontology
- 4.3.2 Semantic Indexing With The Tessi Indexing Engine
- 4.3.3 Semantic Indexing Solution Automates The Indexing Process
- 4.3.4 Information Extraction With Tessi Extraction Engine
- 4.3.5 Semantic Search With Tessi Search Engine
- 4.4 Technology Requirements
5. Computer Assisted Coding Of Medical Information Company Profiles
- 5.1 3m Health Information Systems
- 5.2 Accuro / Codecorrect
- 5.2.1 Codecorrect
- 5.2.2 Revenue Cycle Management Tools Including Medical Coding Software Solutions
- 5.3 Artificial Medical Intelligence Ami
- 5.3.1 Artificial Medical Intelligence Computer Assisted Coding
- 5.4 A-Life Medical
- 5.4.1 Emory Healthcare / A-Life Medical
- 5.5 Ahima Computer-Assisted Coding Software Standards Workshop
- 5.5.1 Collaborative Effort To Establish Standards For Computer-Assisted Coding Applications
- 5.5.2 American Health Information Management Association (Ahima)
- 5.5.3 Athenahealth
- 5.6 Coderyte
- 5.6.1 Coderyte Web-Enabled Workflow
- 5.6.2 Coderyte Technologies And Services
- 5.6.3 Coderyte Customers
- 5.7 Craneware
- 5.8 Language And Computing
- 5.8.1 L&c Customers
- 5.8.2 L&c European Clients
- 5.8.3 L&c And Eclipsys
- 5.8.4 L&c First Databank (Uk)
- 5.8.5 L&c Idewe (Belgium)
- 5.9 Lingologix
- 5.9.1 University Of Texas Medical Branch Electronic Health Network
- 5.9.2 Johns Hopkins University Signs Agreement For Production Use Of Gocode
- 5.9.3 Lingologox Gocode Mayo Clinic
- 5.9.4 University Of Texas Medical Branch Electronic Health Network Pilots Gocode To Automate Coding Of Free Text Encounter Notes
- 5.10 Mds Medical
- 5.10.1 Medical Software And Services For The Medical Industry
- 5.11 Plato
- 5.12 Quadramed
- 5.13 Radiology Business Management Professionals (Rbma)
- 5.14 Wcc
List Of Tables And Figures
Computer Assisted Coding Of Medical Information Executive Summary
- Table Es- Electronic Coding Solution Market Driving Forces
- Table Es-2 Electronic Coding Product Issues
- Table Es-3 Worldwide Natural Language Computer Assisted Coding Software As A Hospital And Physician Services (Saas) Market Shares, Dollars, 2006
- Figure Es-4 Worldwide, Computer Assisted Coding Market Forecasts, Dollars, 2007-2013
- Figure Es-5 Worldwide, Number Of Procedures With Computer Assisted Coding, Market Forecasts, Number, 2007-2013
Computer Assisted Coding Of Medical Information Market Description And Market Dynamics
- Table 1-1 Electronic Coding Integrated Database Issues
- Table 1-2 3m Medical Necessity Online
- Table 1-3 Natural Language Solutions System For Coding
- Table 1-4 Computerized Workflow System Systems Features
- Table 1-5 Confidence Assessment Module System
Computer Assisted Coding Of Medical Information Market Shares, And Market Forecasts
- Table 2-1 Electronic Coding Solution Market Driving Forces
- Table 2-2 Electronic Coding Product Issues
- Table 2-3 Worldwide Natural Language Computer Assisted Coding Software As A Hospital And Physician Services (Saas) Market Shares, Dollars, 2006
- Table 2-4 Worldwide Natural Language Computer Assisted Coding Software As A Hospital And Physician Services (Saas) Market Shares, Dollars, 2006
- Figure 2-5 U.S. Natural Language Computer Assisted Coding Software As A Hospital And Physician Services (Saas) Market Shares, Dollars, 2006
- Table 2-6 Worldwide Natural Language Computer Assisted Coding Software As A Hospital And Physician Services (Saas) Market Shares, Dollars, 2006
- Table 2-7 Platocode Computer Assisted Coding Solution Benefits
- Figure 2-8 Worldwide, Number Of Patients, Market Forecasts, 2007-2013
- Figure 2-9 Worldwide, Number Of Patients With Digital Records, Market Forecasts, Dollars, 2007-2013
- Table 2-10 Worldwide Natural Language Computer Assisted Coding Market Penetration, 2007-2013
- Figure 2-11 Worldwide, Number Of Procedures, Market Forecasts, 2007-2013
- Figure 2-12 Worldwide, Number Of Procedures With Computer Assisted Coding, Market Forecasts, Number, 2007-2013
- Figure 2-13 Worldwide, Computer Assisted Coding, Percent Penetration, Market Forecasts, Percent, 2007-2013
- Figure 2-14 Worldwide, Computer Assisted Coding Market Forecasts, Dollars, 2007-2013
- Table 2-15 Worldwide Natural Language Computer Assisted Coding Market Forecasts, 2007-2013
- Figure 2-16 U.S., Computer Assisted Coding Market Forecasts, Number, 2007-2013
- Figure 2-17 U.S., Number Of Physician Visits Market Forecasts, 2007-2013
- Figure 2-18 U.S., Number Of Patient Procedures, Market Forecasts, Number, 2007-2013
- Figure 2-19 U.S., Number Of Procedures With Computer Assisted Coding, Market Forecasts, Number, 2007-2013
- Figure 2-20 U.S., Computer Assisted Coding, Percent Penetration, Market Forecasts, Percent, 2007-2013
- Figure 2-21 U.S., Computer Assisted Coding, Market Forecasts, Dollars, 2007-2013
- Table 2-22 U.S. Natural Language Computer Assisted Coding Market Forecasts, 2007-2013
- Table 2-23 Total Number Of U.S. Hospitals
- Table 2-24 Total Staffed Beds In U.S. Registered Hospitals
- Table 2-25 Physician Admissions Coding Price Variation Analysis
- Table 2-26 Physician Coding Price Variation Analysis
- Table 2-27 Advanced Practice Management System Benefits
- Table 2-28 Us Number Procedures, 2003-2004
- Table 2-29 Us Number Procedures, 2003-2004
- Table 2-30 Us Computer Aided Coding Number Procedures, 2003-2004
- Table 2-31 Us Natural Language Computer Assisted Coding Market Penetration, 2007-2013
- Table 2-32 Computer Assisted Coding Regional Market Segments, 2006
- Table 2-33 Computer Assisted Coding Regional Market Segments, 2006
Computer Assisted Coding Of Medical Information Products
- Table 3-1 Electronic Coding Solution Functions
- Table 3-2 A-Life Medical Actus(Tm) Application Suite Functions
- Table 3-3 A-Life Medical Fusion Advanced Practice Management System Benefits
- Table 3-4 A-Life Medical Solutions
- Table 3-5 A-Life Medical Services
- Table 3-6 A-Life Medical Actus Application Suite
- Table 3-7 A-Life Medical Coaudit
- Table 3-8 A-Life Medical Has An Active Natural Language Nlp-Based Solutions Development Program
- Table 3-9 Coderyte Systems For Overcoming Documentation Shortfalls Focus
- Table 3-10 Coderyte Systems Topics
- Table 3-11 Coderyte Systems Metrics Included For Computerized Coding
- Table 3-12 Coderyte Web-Based Coding Software Return On Investment Metrics
- Table 3-13 Coderyte Web-Based Coding Software Key Benefits
- Table 3-14 Coderyte Coding Software Functions
- Table 3-15 Coderyte Coding Software Features
- Table 3-16 Coderyte Internet-Based Computer-Assisted Medical Coding Target Markets
- Table 3-17 Coderyte Codeassist Functions
- Table 3-18 Coderyte Codecomplete Functions
- Table 3-19 Lingologox Gocode - Benefits Of Automated E&m Coding
- Table 3-20 Lingologox Gocode Coding Benefits
- Figure 3-21 Lingologix Gocode Benefits
- Table 3-22 Lingologix Gocode Accuracy
- Table 3-23 Language And Computing Ontoloy Advantages Of Automating E/M Coding With Linkcode
- Table 3-24 Language And Computing Ontoloy Oaie Coding Algorithms
- Table 3-25 Language And Computing Mapping And Modeling Disparate Controlled Medical Vocabulary Functions
- Table 3-26 Artificial Medical Intelligence (Ami) Emscribe Dx Benefits
- Table 3-27 A-Life Medical Fusion Advanced Practice Management System Functions
- Table 3-28 3m Apr Drg Solutions Aspects
- Table 3-29 3m Applications For Severity- And Risk-Adjusted Data
- Table 3-30 3m Classification System
- Table 3-31 3m Apr Drg Software Features
- Table 3-32 Ingenix Medicare Fee Schedule
- Table 3-33 Benefits Of 3m Claim Scrubber
- Figure 3-34 How 3m Claim Scrubber Works
- Table 3-35 3m Claim Scrubber Claim Flow
- Table 3-36 3m Claim Scrubber Features
- Table 3-37 Ge 2007 Medicare Reimbursement Information By Product
- Table 3-38 Mckesson Horizon Physician Portal Benefits
- Table 3-39 Mckesson Horizon Hospital Portal Benefits
- Table 3-40 Mckesson Horizon Portal Benefits
- Table 3-41 Athenaenterprise Services Functionality
- Table 3-42 Ge Centricity Pm Features
- Table 3-43 Cerner Physician Enterprise Application Suite Functions
- Table 3-44 Siemens Unity Financials Registration And Billing Applications Key Features
- Table 3-45 Siemens Unity Financials Transactions Within Workflows Functions
- Table 3-46 Siemens Unity Support For Organizational Business Goals
- Table 3-47 Mckesson Horizon Practice Compliance Modules
- Table 3-48 Mckesson Horizon Practice Compliance Module Benefits
- Table 3-49 Mckesson Horizon Practice Imaging Module Benefits
- Table 3-50 Nextgen Emr Physician Practice Electronic Medical Records System Benefits
- Table 3-51 Nextgen Emr Functions Report # Sh29821526 246 Pa
- Table 3-52 Meditech Physician Practice Solution Management
- Table 3-53 Meditech Mpm Suite Suite Components
- Table 3-54 Mds Medical / Allscripts Touchchart Electronic Health Records Software Benefits
- Table 3-55 Mds Medical Electronic Health Record Benefits
- Table 3-56 Mds Medical / Allscripts Touchchart Emr Software
- Table 3-57 Mckesson Horizonwp Physician Portal Module Benefits
Computer Assisted Coding Of Medical Information Technology
- Table 4-1 Semantic Indexing Benefits L&c's Linkbase Medical Ontology
- Figure 4-2 L&c's Linkbase Semantic Process Flow Index Component Medical Ontology
- Table 4-3 Information Extraction With Tessi Extraction Engine Functions
- Figure 4-4 L&c Tessi Indexing L&c Tessi Search
- Table 4-5 Resulting Template With Extracted Information
- Figure 4-6 Semantic Extraction By Tessi Semantic Indexing By Tessi
Computer Assisted Coding Of Medical Information Company Profiles
- Table 5-1 Artificial Medical Intelligence Computer Assisted Coding Solution Benefits
- Table 5-2 Ahima Computer-Assisted Coding Software Standards Directions
- Table 5-3 Coderyte Overview
- Table 5-4 Lingologix Automated Coding With Gocode Benefits