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

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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:

Fathom is an autonomous medical coding platform that provides accurate, complete, touchless coding for ICD, CPT/HCPCS, E/M, modifiers, provider assignment, units, shared services, deficiencies, and all other required coding elements across specialties. With Fathom, providers benefit from:

  • 90%+ successful automation rates: Of all patient encounters provided to Fathom for coding, around 90% or more are successfully coded autonomously or correctly flagged for documentation deficiencies.
  • 96%+ accuracy rates: Ongoing audit programs ensure greater-than-human coding accuracy.
  • 30-50% cost savings: Fathom delivers an average 42.3% reduced cost to code.
  • Denials reduction: Stronger accuracy and immediate flagging of documentation deficiencies fix coding errors upstream and reduce denials.
  • RVU increase: Through higher coding accuracy, especially on E/Ms, Fathom typically results in a meaningful improvement to revenue capture.
  • Lightning-fast turnarounds: Fathom typically returns complete coding results for the day's encounters within 2 hours, averaging 57 min.
  • Industry-leading SLAs: Contractual commitments to guarantee performance for automation, accuracy, turnaround time, and other metrics.

Through a risk-free trial, Fathom enables providers to validate our coding quality for themselves before turning on production-ready models upon go-live. In production, Fathom receives clinical documentation from EMRs following patient visits, fully codes the encounters according to guidelines and payer rules, and returns complete coding results for claim submission. This consistent application of coding guidelines improves outcomes and enables enterprise-wide compliance.

About Fathom:

Fathom is an autonomous medical coding platform that uses deep learning and LLMs to provide accurate, complete coding for E/M, CPT/HCPCS, ICD, provider assignment, deficiencies, and other coding elements across specialties.

Compatibility level

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

Clients

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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:

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:

Fathom is an autonomous medical coding platform that provides accurate, complete, touchless coding for ICD, CPT/HCPCS, E/M, modifiers, provider assignment, units, shared services, deficiencies, and all other required coding elements across specialties. With Fathom, providers benefit from:

  • 90%+ successful automation rates: Of all patient encounters provided to Fathom for coding, around 90% or more are successfully coded autonomously or correctly flagged for documentation deficiencies.
  • 96%+ accuracy rates: Ongoing audit programs ensure greater-than-human coding accuracy.
  • 30-50% cost savings: Fathom delivers an average 42.3% reduced cost to code.
  • Denials reduction: Stronger accuracy and immediate flagging of documentation deficiencies fix coding errors upstream and reduce denials.
  • RVU increase: Through higher coding accuracy, especially on E/Ms, Fathom typically results in a meaningful improvement to revenue capture.
  • Lightning-fast turnarounds: Fathom typically returns complete coding results for the day's encounters within 2 hours, averaging 57 min.
  • Industry-leading SLAs: Contractual commitments to guarantee performance for automation, accuracy, turnaround time, and other metrics.

Through a risk-free trial, Fathom enables providers to validate our coding quality for themselves before turning on production-ready models upon go-live. In production, Fathom receives clinical documentation from EMRs following patient visits, fully codes the encounters according to guidelines and payer rules, and returns complete coding results for claim submission. This consistent application of coding guidelines improves outcomes and enables enterprise-wide compliance.

Pediatric use cases:

None provided

Users:

Health systems, hospitals, physician groups, ambulatory providers, risk-bearing providers, health plans, and other organizations.

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, Pop health platform, Home health

EMR Integration & Relevant Hardware:

Use case dependent

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, eClinicalWorks, Athenahealth, MEDHOST, Self-developed

Hardware Compatibility:

Not applicable

Client Types

Awards

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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:

None provided

Differentiators vs Competitors:

None provided

Health Equity

Keywords

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Fathom is a medical coding AI

Videos

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Downloads

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CodaMetrix Differentiators 1-Pager - August 2024 (2).pdf

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