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Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Awards
Differentiators
Health equity
Keywords
Media
Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Awards
Differentiators
Health equity
Keywords
Media
Company details
XpertCoding
XpertCoding

Categories

Solutions

Description

Product Description:

XpertCoding uses advanced AI, NLP, and RPA technologies to automate over 90% of medical coding tasks, processing claims within 24 hours. XpertCoding's AI-powered coding system maintains a 98% accuracy rate and reduces coding costs by over 50%. 

XpertCoding also includes a Business Intelligence suite with a Clinical Documentation Improvement (CDI) Dashboard and a Comprehensive Data Analytics Dashboard, providing essential insights for healthcare leaders and teams to optimize operations.

About XpertDox:

XpertDox is a healthcare technology company committed to reducing administrative burdens for physicians, healthcare teams, and leaders while enhancing patient care through AI-driven solutions. XpertDox employs AI, RPA, and Big Data technologies to improve healthcare outcomes.

XpertDox's commitment to innovation is demonstrated by its flagship product, XpertCoding, an autonomous medical coding software with Clinical Documentation Improvement(CDI) designed to accelerate the revenue cycle by processing medical claims with high accuracy in less than 24 hours.

XpertDox was founded in 2015 and is currently based in Scottsdale, Arizona.

Product Description:

CodaMetrix is a SaaS platform, hosted in the AWS Cloud environment, that uses AI and ML to interpret clinical data from the Electronic Health Record (EHR) to reduce time and cost of coding while increasing the quality of coding data sets. It works in parallel with existing coding processes, automatically billing codes and providing medical coding teams with context and suggestions for low-confidence codes. 

CodaMetrix currently supports Epic, GE, Meditech, and Cerner and can be expanded to other EHRs. It is available in Radiology, Pathology, Endoscopy, Surgery, and Evaluation & Management service lines with planned expansion into Emergency Department (ED) and other specialties. CMX Insights includes a dashboard with analytics on automation rate and accuracy, as well as Coding Decision Support tools.

About CodaMetrix, Inc.:

CodaMetrix is an AI-powered SaaS platform dedicated to transforming medical coding, serving health systems that use Epic in more than 220 hospitals, performing over 50 million patient visits with 60,000 physicians across 25 states. The CodaMetrix platform leverages the latest in AI technology to deliver automation in a growing number of specialty and sub-specialty areas. Providers using CodaMetrix experience a 60% reduction in coding costs, a 70% reduction in claims denials, a 5-week acceleration in time to cash, and an average successful automation rate above 96%.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Product Capabilities

CodaMetrix leverages AI technologies in our platform to learn relationships between clinical documentation and billing codes, as well as to adapt to each customer's unique documentation styles and coding standards. We develop and maintain our own proprietary AI algorithms in-house, including machine learning, deep learning, and natural language processing capabilities. We do not rely on or partner with any third-party AI/machine learning vendors.

The CMX Insights™ Platform displays information about charge related data received from the Customer’s EHR system, including cases which have been automated and those that have been passed along to the Customer’s existing manual solution or processed manually. The analytics can be accessed to understand why a charge was automatically coded and provides evidence of all coding decisions and predictions. Finally, CMX Insights™ are used to analyze volumes processed by date range, and case-specific information. Dashboards include but are not limited to: - Real-time performance - Financial impact analytics - Productivity monitoring - Denial management tracking

CodaMetrix has implemented both the technical and procedural safeguards to operate with HIPAA compliance at the forefront. CMX has achieved ISO 27001 certifications and SOC 2 Type 2 compliance in addition to implementing the necessary controls (encryption in motion and at rest, full audit trail, ISMS, 3rd party penetration testing, static and dynamic code vulnerability scanning, role-based security, least privileged security model, etc).

CodaMetrix is committed to reducing denials through our autonomous coding solution. We have proven to reduce denials by more than 50-60% compared to manual coding. For example, a study of radiology claims at Mass General Brigham showed that denials-for-coding dropped by more than 58.7% after implementing CodaMetrix. We also analyze denials information shared by customers to improve our artificial intelligence and autonomous coding capabilities.

Use Cases

Description:
  1. Healthcare systems, hospitals, and practices can harness XpertCoding to expedite claim submissions, boost accuracy, reduce costs, and alleviate physician burden.
  2. RCM companies can utilize XpertCoding to expedite claim processing, improve accuracy, and deliver cost savings for their clients.
Pediatric use cases:

XpertCoding is implemented at multiple pediatric practices where it automates the medical coding process.

Users:
  • Urgent Cares
  • Pediatric Practices
  • Primary Care Practices
  • Obstetrics & Gynecology Practices
  • Healthcare Systems
  • Hospitals with large urgent care, pediatrics or primary care presence
  • Any other medium to large single-specialty practices
Description:

CodaMetrix provides autonomous coding services for the following specialties for both inpatient and outpatient scenarios:

  • Diagnostic Radiology
  • Interventional Radiology
  • Anatomic Pathology
  • GI and Special Procedures
  • Surgery
  • Bedside Professional Visits
  • ED expected in 2025 
  • Ambulatory expected in 2025
Pediatric use cases:

Yes, CodaMetrix is currently contracted with Children's Health Systems. 

Users:

The primary users of the CodaMetrix platform are designated Medical Coders. A goal of our system is to alleviate doctors of the task of medical coding and other administrative burdens.

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR

EMR Integration & Relevant Hardware:

Required

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, MEDHOST, MedWorx, Healthland, QuadraMed, Self-developed

Hardware Compatibility:

Not applicable

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, Pop health platform, ADT, Access +/or revenue cycle

EMR Integration & Relevant Hardware:

Use case dependent

EMRs Supported:

Epic, Cerner, Other, Meditech, athena, Athenahealth, GE

Hardware Compatibility:

Mobile / Tablet (web optimized), Desktop

Client Types

Awards

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Differentiators

Differentiators vs EHR Functionality:
  1. XpertCoding is an AI-powered, fully autonomous medical coding solution, whereas EHRs only offer computer-assisted coding that requires provider input and a coding team.
  2. XpertCoding provides a Dashboard to monitor claims and perform advanced analytics across all their location, whereas EHRs do not offer a coding-focused Dashboard.
  3. XpertDox offers a Clinical Documentation Improvement module not offered by most EHRs.

Differentiators vs Competitors:
  1. XpertCoding can autonomously code >90% of the claims, whereas competitors may only code 60 to 80%.
  2. XpertCoding offers free coding services for one month, whereas most competitors don't.
  3. The training period for XpertCoding is less than four weeks, compared with many months and even a year with some competitors.
  4. XpertCoding offers a comprehensive Dashboard for monitoring, data analytics, CDI, and audit trail. The competitor's Dashboard may or may not be as robust.
  5. XpertCoding does not require any IT support from clients, whereas many competitors require some help from the IT team.
  6. XpertCoding is HIPAA, ISO27001, and SOC2 Type 2 certified from a security perspective, whereas some competitors do not carry such certifications.
  7. XpertDox is ISO22301 certified for business continuity, whereas some competitors may not have the certification.
Differentiators vs EHR Functionality:
  • Codametrix offers fully autonomous coding vs. computer assisted coding (suggested code sets) 
  • Professional coder productivity reporting
  • Ease of performing QA and auditing with Coding Manager tools for self service coding QA (including building in custom rules and sampling)
Differentiators vs Competitors:
  • Automation Accuracy: CodaMetrix exceeds 96% in this metric, setting a new standard for the industry.

  • Coding quality: CodaMetrix is built on clinically validated data to ensure superior accuracy and provides the adaptability necessary to serve your specific needs.

  • CodaMetrix offers CMX Amplify™—our coding decision support tool that measures coder productivity, accuracy, and proficiency, while helping generate high-quality data.

  • Performance analytics: The CodaMetrix platform's advanced analytics capabilities position users to make data-driven decisions more effectively. 

  • Provider-owned: CodaMetrix is a provider-owned company that is organizationally designed to deliver proven solutions to our fellow healthcare industry providers.

  • As the Epic Toolbox member that has been live with numerous Epic healthcare organizations for years, we bring unmatched experience to the market, consistently meeting Epic’s integration requirements.

Health Equity

Keywords

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Videos

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Downloads

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XpertDox White Paper-Business Continuity Strategies in AI Medical Coding.pdf
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CodaMetrix Differentiators 1-Pager - August 2024 (2).pdf

Alternatives

Company Details

Founded in 2015

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