AGS AI PLATFORM
Computer-Assisted Professional Coding (CAPC)
Streamline your professional coding process with improved charge capture while reducing denials and improving quality and compliance.
Overview
Enhance professional coding productivity and code capture.
The AGS AI Platform’s Computer-Assisted Professional Coding (CAPC) module is powered by an industry-leading clinical NLP engine that’s built explicitly for professional-fee coding. It ensures precise coding across all professional specialties, encompassing ICD-10 CM, CPT, HCPCS, modifiers, and professional E&M levels. The module’s integrated workflow simplifies coding tasks and facilitates the abstraction of multiple parameters efficiently.
NLP-Based CPT and E&M Code Automation
Leverages NLP to automatically suggest billable codes from different types of clinical documents.
One-Click Coder Validation and Acceptance
Automatically identifies charts that have potential queries for seamless validation and acceptance.
Always Up to Date
Our clinical content team ensures that all coding guidelines are maintained whenever new codes or rules are released. Additionally, our Clinical NLP engine is always learning and improving based on coder actions
Features
Computer-Assisted Professional Coding Software Features and Capabilities
Intelligent Worklists
Prioritize and group work
Charts are placed into coder work queues upon readiness, paused if awaiting additional information, and automatically returned to the queue upon chart completion for final coding.
Align coder expertise with chart categories
Enhance your team’s efficiency by aligning tasks with individual skills and experience levels. Automatically route charts to team members based on specialty or diagnosis group criteria.
Reassign tasks according to availability
Effortlessly transfer tasks between coders based on their availability and workloads throughout the organization.
Automated and Accurate Coding Suggestions
Ensure comprehensive capture of diagnosis codes
Utilizing advanced Clinical NLP technology and deep knowledge graphs, all possible CPT codes are identified, whether explicitly stated or implied through other treatments, lab results, or medications.
Capture all charges
Every CPT, HCPCS, or relevant charge code is captured across all parts of the documentation, including attachments.
Automatically recommends E&M codes
Evaluation and management codes are automatically suggested based on current criteria, utilizing either total time or pertinent factors to optimize the documented level.
Built-in HCC and RAF Module
Automatically capture HCC categories
The CAPC module automatically aligns the assigned codes for each visit with the relevant HCC category, encompassing both CMS and HHS HCC models.
Continuous RAF score updates year-round
Aggregate coded HCC categories throughout the year, applying disease hierarchies automatically and accurately calculating RAF scores by combining demographics and other parameters across individual encounters, consolidating all visits into a comprehensive risk model.
Actionable, Real-Time Analytics
Assess coder efficiency
Track coder activities, including chart viewing and editing, with precision down to the second. Utilize this data to evaluate hourly and daily productivity, and compare against established baselines and accuracy rates.
Gain insights into coding trends
Analyze the codes utilized by individual physicians, facilities, and coders to understand the services rendered and the specific patient demographics served by your organization.
Identify areas requiring attention
Direct your focus towards coders who require assistance in enhancing productivity or physicians who deviate from typical coding patterns.
ADDITIONAL FEATURES
Enhance your experience with Computer-Assisted Professional Coding through these advanced features.
Code Auditing and Compliance
Protect your reputation and hard-earned revenue with thorough and accurate auditing led by advanced AI and automation.
With increased regulatory scrutiny and the continuously shifting landscape of rules and regulations, healthcare organizations and their revenue cycles face mounting pressures. Profit margins are being squeezed while valued reputations face increased risk. To help ease these burdens and ensure compliance, AGS Health offers a fully integrated auditing solution to support CAPC users.
Features
- Intelligent audit worklists automatically queue and prioritize charts for auditing and allow your team to concentrate on the audits that matter most.
- Advanced case-search and selection features enable case sampling across a variety of parameters.
- Conduct pre-bill and retrospective audits designed to ensure quality without billing delays.
- Automated audit suggestions with the ability to assess predicted coding against final coding, spot missing documentation, and perform targeted audits based on a given specialty, provider, or coder.
- Actionable audit reporting allows users to view and compare chart data, track audit results, and identify education opportunities quickly and easily.
Benefits
- Enhance medical coding accuracy by automatically detecting errors and inconsistencies.
- Significantly reduce the amount of time and resources required for audits.
- Ensure adherence to coding guidelines and regulations to avoid penalties and maintain compliance.
- Avoid claim denials and rework resulting from coding errors.
- Gain valuable insights and analytics on coding trends.
- Improve teamwork and alignment through collaborative features, including chat, change tracking, and feedback comparisons.
Merit-based Incentive Payment System
Streamline and optimize your MIPS Quality Initiatives with our MIPS module.
Consolidate your coding and MIPS coding processes into a more streamlined and efficient workflow with the optional add-on MIPS module for the computer-assisted professional coding (CAPC) platform. This module enables you to configure edits for the measures you participate in, which then alerts the coders early on during the coding process for potential MIPS scenarios.
Features
- Configuration of alerts for all MIPS quality measures
- Automated screening of charts using NLP suggested codes, triggering edits for charts qualifying for MIPS measures
- MIPS coding and review workflow ensures quality of the MIPS qualification and coding process
- Integrated workflow between coding and MIPS team for cases that need to be sent back to coding
- Real-time insights with interactive dashboards and reports on the patient’s record, including address verification.
Benefits
- Proactive MIPS alerting and resolution within the coding process
- Reduced false positives in number of cases that need to be reviewed by MIPS coders and reviewers, resulting in faster MIPS processing
- Integration with your MIPS reporting system
- Collaboration between coding and quality teams improves the efficiency and quality of the MIPS review process
BENEFITS
Experience the impact of Computer-Assisted Professional Coding.
From group practices to multi-facility health systems, our Computer-Assisted Professional Coding helps maximize the performance of your coding operations with improved throughput and quality.
Encoders and Groupers
Integrated Encoder
CAPC comes with a built-in ‘book-based’ encoder, helping you select the right code with full supporting guideline information and coding clinics.
Integrated References
An integrated reference guide provides detailed visuals and anatomical information for coders to reference during the coding process.
CAPC Software Case studies
Resources
Dig deeper into Computer-Assisted Professional Coding
Integrations
Connects with any system
More Technology
Intelligent Authorization
Automate your financial clearance processes through to improve efficiency, lower costs, avoid authorization-related denials, and enhance the patient financial experience by expediting access to necessary services.
Autonomous Coding
Achieve true coding autonomy through advanced artificial intelligence and award-winning services in one seamless, effortless solution.
Computer-Assisted Coding
Transform your manual coding workflow into an AI-coder collaboration that positively impacts your coding quality, CMI and DNFC.
Computer-Assisted CDI
Automate the review of clinical documentation and queries without using a single spreadsheet.
Code Auditing
Streamline your audit process before or after submitting the claim to ensure the right diagnosis and charge codes are being used.
Revenue Cycle Automation Analytics
Manage and forecast your automated revenue cycle management workflows for peak performance.
Analytics & Reporting
See your data like never before without the constraints of your EHR reporting capabilities.
Clinical NLP APIs
Natural Language Processing APIs that enable you to extract meaningful clinical entities from bundles of unstructured data, seamlessly.
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