SYSTEMS AND METHODS FOR EFFICIENT HANDLING OF MEDICAL DOCUMENTATION

摘要

Systems and methods for efficient medical chart review are provided. In some embodiments, medical records are received. The admissibility of each record is then determined. Next, a condition and MEAT assessment is generated for the medical records. The condition and MEAT determination each have a corresponding confidence. A determination may be made whether human quality assurance is required. If so, the medical records may be routed to one or more coders for human review. In addition, the systems and methods may also perform an audit analysis on the records, which identifies codes which have been submitted and have insufficient evidence. Lastly, a cost metric for the patient based upon the condition and MEAT determination may be generated.