Avia Logo

Compare Products


Jump to:
Categories
Solutions
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:

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%.

Product Description:

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

What organizations can expect from XpertDox:

Unmatched Automation and Accuracy

  • Fully Automated Medical Coding: Automates 94% of claims without human review, ensuring speed, accuracy, and efficiency with minimal supervision.
  • Performance-Based Coding: Tracks quality and performance metrics effectively with support for Category II CPT codes.
  • Reduces Coding Errors to Less Than 1%: Ensures compliance and minimizes claim denials, delivering precise and consistent coding outcomes with >99% coding accuracy
  • Corrects 20% of Erroneous ICDs and 40% Erroneous CPTs for organizations: Improves coding quality and ensures accurate submissions for optimal financial outcomes.
  • Faster Claim Processing in less than 24 Hours: Accelerates claim submission timelines, ensuring faster reimbursements and reduced backlogs.
  • Smart Claim Scrubber: Customizable to align with payor-specific rules, reducing denials and rejections for smoother claim submissions.
  • EMR or EHR-Agnostic Solution: Enables easy data extraction and Fully Automated Claim Submission, ensuring uninterrupted workflows with any EMR or EHR system.
  • Modifies and Improves 80% of Claims: Streamlines workflows, eliminating bottlenecks and enhancing operational efficiency.

Enhanced Financial Outcomes for Clients

  • Flexible Pricing Model: Offers transparent, per-claim pricing for scalable and cost-effective solutions tailored to your needs.
  • Delivers a 15% Increase in Charge Capture: Optimizes revenue generation and ensures accurate billing practices.
  • Reduces Claim Denials by 22%: Strengthens the revenue cycle and minimizes payment delays.
  • Drives 23% Growth in PMPM Payments: Boosts practice revenue by up to 19%, significantly enhancing financial performance.

Revenue Cycle Optimization and Advanced Insights

  • Revenue Cycle Dashboard: Provides real-time visibility into key performance metrics and financial health, empowering data-driven decisions.
  • Clinical Documentation Improvement (CDI): Optimizes compliance and documentation accuracy for improved financial outcomes and streamlined workflows.
  • Advanced Analytics Suite: Benchmarks provider and clinic performance with actionable insights, helping healthcare teams make informed, strategic decisions.
  • Proactively Recovers Missed Charges: Identifies and retrieves overlooked charges from previously submitted claims, enhancing revenue integrity.

Secure and Risk-Free Implementation

  • HIPAA-Compliant Infrastructure: Ensures secure data privacy and full regulatory compliance, offering peace of mind for healthcare organizations.
  • Risk-Free Implementation: Includes zero upfront fees and a complimentary first month, allowing you to experience the benefits without risk.
  • ISO 27001, ISO 22301, SOC2 Type II compliant

Proven Results

  • Reduces charge entry lag by 40%, ensuring timely claim submissions. Achieves less than 1% coding errors, significantly improving compliance and reducing denials.
  • Enhances efficiency and accuracy, enabling healthcare teams to focus more on delivering high-quality patient care.

XpertCoding by XpertDox

XpertCoding is XpertDox's premier autonomous medical coding platform, designed to accelerate the revenue cycle with unmatched accuracy and efficiency. With risk-free implementation, zero upfront fees, and a complimentary first month, healthcare organizations can experience the transformative benefits of XpertCoding firsthand.

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.

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.

XpertCoding uses AI, NLP, ML, Big Data, and RPA to automate medical coding, processing claims in under 24 hours. It achieves a 94% automation rate, reduces coding errors to less than 1%, and corrects discrepancies in ICDs and CPTs. The platform connects effortlessly with EMR or EHR systems without IT support and works across small to large practices, RCM organizations, billing companies, and large healthcare systems.

XpertCoding provides real-time monitoring, CDI feedback, predictive analytics for denial management, and benchmarking tools to identify areas for improvement. It offers coding insights, granular analysis, and fee schedule alerts to enhance coding accuracy and revenue optimization. Customizable dashboards allow healthcare leaders to monitor KPIs and streamline operations effectively.

XpertCoding meets high standards for data security and compliance with certifications in HIPAA, SOC 2 Type 2, ISO 27001, and ISO 22301. It offers detailed audit logs, robust encryption, and business continuity measures to ensure secure and uninterrupted operations.

The platform provides CDI feedback, benchmarking against industry standards, and alerts for CPT anomalies to reduce denials and improve accuracy. It supports ongoing training and real-time performance monitoring to drive continuous efficiency and maximize revenue potential.

Use Cases

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.

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

EHR Integrations

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

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, Home health, Behavioral health, Community based organizations, Access +/or revenue cycle

EMR Integration & Relevant Hardware:

Use case dependent

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

Client Types

Awards

edit-media
edit-media
No awards image

Differentiators

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.
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:

XpertCoding Differentiators

  1. XpertCoding Achieves Automation Rates Exceeding 94%. Far surpassing competitors who typically automate only 60-80% of claims, XpertCoding minimizes manual intervention, ensuring faster and more accurate claim processing.
  2. Designed for a Wide Range of Organizations: Unlike most competitors XpertCoding is built to work with RCM organizations, billing companies, small practices, healthcare systems, and hospitals, providing scalable solutions that adapt to the unique needs of any healthcare setup. 
  3. Risk-Free Trial with Complimentary Coding Services for One Month: Unlike most competitors, XpertCoding offers a no-cost trial, allowing organizations to experience the platform's capabilities before committing.
  4. Rapid Implementation with Minimal Training Time: It requires less than four weeks for onboarding and claim processing, compared to competitors' lengthy timelines, which may span several months or even a year.
  5. Comprehensive and Robust Dashboard: Provides real-time monitoring, advanced data analytics, Clinical Documentation Improvement (CDI), payer-specific performance analytics, and a detailed audit trail, empowering healthcare teams with actionable insights.
  6. Customizable Smart Claim Scrubber: Tailored to align with payor-specific rules, reducing claim denials and rejections to ensure smoother claim submissions.
  7. Seamless Connection Without IT Support: XpertCoding connects easily with any EMR or EHR system and operates without requiring IT support from clients, making implementation hassle-free.
  8. Certifications for Security and Compliance: Fully certified for HIPAA, ISO 27001, and SOC 2 Type 2, guaranteeing the highest standards of data privacy and regulatory compliance.
  9. ISO 22301 Certified for Business Continuity: Ensures uninterrupted service delivery during disruptions, providing operational resilience unmatched by many competitors.
  10. Proactive Charge Recovery and Revenue Optimization: Identifies and retrieves missed charges on previously submitted claims, optimizing revenue integrity. 
  11. XpertCoding aligns billing with payor-specific contracts, ensuring precision and compliance.
  12. Category II Coding and Value-Based Care Support: Supports Category II CPT codes, enabling organizations to track quality metrics effectively and integrate seamlessly with value-based care frameworks.
  13. Optimized for FQHCs and Medicaid Providers: Fully compliant with FQHC requirements and Medicaid coding guidelines, XpertCoding ensures organizations remain compliant while maximizing revenue cycle efficiency.
  14. Modifier Support for Enhanced Claim Accuracy: Provides full support for modifiers, ensuring accurate coding for services with special circumstances. 
  15. Compared to other competitors in autonomous or AI-assisted coding, XpertDox has demonstrated results across various organization types.
  16. Designed to scale for RCM and Billing Companies: Streamlined operations, reduced coding errors, and accelerated claim submissions.
  17. Optimal for Mid-to-large scale Practices: Minimal IT requirements and transparent pricing models make XpertCoding an ideal fit for smaller setups.
  18. Hospitals and Healthcare Systems: Comprehensive dashboards, charge recovery, and CDI tools support enterprise-level needs.
  19. Faster Claim Processing and Reduced Lag: Reduces charge entry lag by 40%, enabling faster claim submission and reimbursement cycles.
  20. Improved Accuracy and Compliance: With coding errors reduced to less than 1%, XpertCoding ensures better compliance and fewer denials.

Health Equity

Keywords

Images

No images provided

1 of 9

edit-media
XpertCoding vs. Others.JPG

Videos

No videos provided

1 of 1

edit-media

Downloads

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

Alternatives

Company Details

Founded in 2015

team illustration
Share your product comparison with your collegues.

Need help narrowing down products?

Add more criteria to see your compatibility level for every vendor. It only takes a few minutes, just create a free account to get started.
back to top