Coding InSight—the first in a planned suite of Healthcare Risk Management applications powered by our HealthData Engine—proactively identifies high-risk patients to improve code capture at the point of care by uncovering prospective and / or missed coding opportunities in near-real time. These insights enable institutions to improve patient care planning and successfully manage risk-based reimbursements.
Coding InSight leverages our proprietary Talix Taxonomy and Talix NLP to deliver a fully automated method of analyzing vast amounts of patient data—structured and unstructured—to identify missed coding opportunities prospectively, at the point of care, and retrospectively. We understand that time with patients is valuable. We make it easy for providers to quickly review relevant patient data and glean insights that help to optimize care planning and delivery.
The Centers for Medicare and Medicaid Services (CMS) and many payer organizations use risk adjustment to predict patient costs and calculate reimbursement rates. For every potential coding opportunity identified, Coding InSight calculates an associated risk adjustment factor (RAF) score in real-time based on our HealthData Engine’s powerful inference technology and sophisticated clinical rules so healthcare providers can more accurately identify high-risk patients and deliver timely interventions.
Coding InSight’s comprehensive dashboard delivers real-time, actionable data that enables better management of financial impacts in the risk adjustment market. Advanced reporting helps maintain program integrity and reduce audit risks.
Coding InSight tightly integrates with any EHR and other coding applications to enable easy workflow integration for improved user productivity.
“Coding InSight has transformed the coding and risk adjustment processes for Village Family Practice. It has improved not only coding efficiency, but more importantly, the level of care we’re able to provide to our patients. As a practice, we are now coding for care rather than for dollars.”
— Clive Fields, MD, President of Village Family Practice