Medical coders work on hundreds of encounters in an average day, dedicating thousands of hours each year to manage their workload quickly and accurately. That amount only increases when factoring in training hours to respond to industry changes and updated provider and insurance guidelines each year.
At Fathom, they have created a technology platform that will not only return valuable time to medical coders but will also empower them to focus on higher-value work, doing the heavy lifting by fully automating daily coding tasks like coding an encounter straight to bill. However, with any advance in technology comes the natural fear that the right automated system will replace human operators, leaving them without a career as technology advances forward.
As VP of Commercial Operations Amit Jayakar explains, Fathom is the rare technology that does not replace human operation but enhances it – which means medical coders will be equipped with the tools to perform their jobs more effectively than ever before.
“Let’s say that in an average day a coder looks at 100 encounters as part of their regular productivity, but in those 100 encounters there are maybe 8 of them that are really complicated and important, the stuff that gets denied by insurance companies and is a reimbursement and revenue risk to the organization,” Jayakar says.
“Right now, they don’t have the bandwidth to properly investigate those 8 encounters because they have 92 other encounters that they have to code. With our models, Fathom can handle the ‘legwork’ by autonomously fully coding the majority of the 92 encounters so that human coders can shift their focus on more important, higher-risk work.”
Fathom uses deep learning technology and a massive database of hundreds of millions of data points to automate the coding process for the largest outpatient services – including emergency medicine, radiology, and primary care. By leveraging Fathom’s technology on simple, everyday encounters, medical coders will be free to focus on the work that requires their experience and expertise. It also means that they will not lose valuable work time on retraining when there are changes to industry guidelines. Fathom automatically updates the platform based on the most recent guidance from insurance payers and healthcare sites – the equivalent of instantly training an entire workforce of thousands.
“When something gets updated, it rolls across the entire system, so it is being applied across the board for every applicable encounter,” Jayakar says.
When human coders are empowered to spend more time on high-value work, they are not the only ones to benefit. The organization itself will see a greater return when they can free their workforce to focus on the most important evaluations. Coders who do not have to spend time on tedious, time-consuming coding tasks will now have the ability to focus on projects that generate massive returns for the healthcare provider.
“One of the largest issues in medical billing is submitting a charge and it gets denied by insurance companies, and then you have this constant back-and-forth about how it should be paid,” Jayakar says. “If you can have a coder manage audits and denials more actively, you can reduce any reimbursement revenue risks.”
Reallocating resources will not mean eliminating the workforce but instead placing them in a position where they can more effectively help the organization. And when this happens, the healthcare provider will generate impressive returns.
“In any given year, when claims are denied, you might collect 60 cents on the dollar for that bill,” Jayakar says. “If you actively manage that, you can increase it to 75 or 80 cents on the dollar. So the end goal is that you increase the return on your investment.”
As Fathom continues to share its deep learning technology with healthcare providers nationwide, they recognize that there are still some doubts to overcome. But one primary concern – that Fathom will replace human coders – is unfounded. Instead, the revolutionary tech company is working in connection with the workforce, enabling them to perform their jobs more effectively by giving them the time they need most.
“At Fathom, we don’t replace coders,” Jayakar says. “We empower them.”
To discover how Fathom assists medical coders with deep learning technology, visit www.fathomhealth.com.
