Overview

A large provider organization in the United States, with a monthly visit volume of 231,360, faced several challenges in their revenue cycle. Adopting Arintra's AI powered autonomous medical coding solution brought a significantly positive impact from November 1 to November 30, 2022, marking a transformative change for the organization.

Challenges

• 75% physician coded charts were billed directly
• 10% denial rate
• High volume low dollar claims
• Massive coding backlogs
• Shortage of medical coders

These challenges collectively resulted in an annual loss of $12 million for the provider organization.

Solution

Arintra’s powerful autonomous medical coding technology addressed these multifaceted challenges by leveraging deep learning, NLP, clinical LLMs and generative AI. The seamless and secure bi-directional integration with the provider organization’s existing EHR required zero IT lift and ensured zero workflow change. Arintra autonomously processed every patient chart, consistently applied business rules and generated precise direct-to-billing charges and codes. It automated an impressive 696 charts per hour, significantly expediting the coding process. By automating the routine coding tasks, Arintra freed providers from coding workload and gave them more time to provide optimal patient care.

Results

Arintra addressed all the challenges and increased the average monthly revenue by 4% for the large provider organization. A significant 41% drop in claim denial rate showcased Arintra's prowess in enhancing coding accuracy. Moreover, Arintra's implementation led to a commendable 22% reduction in coding backlogs, ensuring a smoother workflow.