Hybrid Human and Computer-Assisted Coding Workflow

摘要

A computer system increases the efficiency with which billing codes may be generated based on a chart, such as a medical chart. The computer system provides the chart to a computer-assisted coding (CAC) module, which produces an initial set of billing codes and an initial assessment of the accuracy and/or completeness of the codes. The computer system decides whether to send the initial set of billing codes to an initial human reviewer. If the computer system sends the initial set of billing codes to the initial human reviewer, then the initial human reviewer reviews the chart and the output of the CAC module, and attempts to fix errors in the CAC output. The system provides the chart and the current (initial or modified) codes to a final human reviewer, who may be more highly skilled than the initial human reviewer, for final verification and modification.

主权项

1. A method performed by at least one computer processor executing computer program instructions stored on at least one non-transitory computer-readable medium, the method comprising:
(A) receiving data representing a medical chart; (B) providing the medical chart to a computer-assisted coding (CAC) module; (C) receiving an initial set of billing codes from the CAC module; (D) providing the initial set of billing codes to an initial human reviewer; (E) receiving, from the initial human reviewer, a modified set of billing codes and data representing an assessment of accuracy and completeness of the initial set of billing codes; and (F) providing the medical chart and the modified set of billing codes to a final human reviewer.