Douglas Green, Healthcare, Podcasts, TR Daily Update eBulletin
January 13, 2025
“And I developed this set of tools to relieve clinicians from the burden of data entry at the point of care, hospitals, outpatient clinics, so on,” says John Bright, Founder and Managing Director, of Med Claims Compliance (MCC). “That’s what we do. We call it a technology-enabled service because we’re providing a service with the technology.”
With 80% of medical bills containing errors and costing Americans $210 billion annually, the healthcare industry faces a crisis in documentation, coding, and revenue accuracy, despite huge technological advancements in the industry.
Nearly 75% of healthcare professionals say the time or effort needed to complete clinical documentation hampers patient care.
Over 77% of healthcare professionals report working after hours due to excessive documentation demands.
That’s why AI-driven solutions, paired with human expertise, are becoming essential for reducing these costly inefficiencies. It’s estimated that AI could solve the healthcare sector’s $500 billion annual administrative problem.
In an industry increasingly reliant on technology, ensuring that AI is guided by human expertise is key. Med Claims Compliance leverages AI and Human-in-the-Loop (HITL) Machine Learning to transform medical claims processing.
“It’s a SAS model. The service is that we can generate correct, compliant medical records at the point of care for a doctor who is using his voice or her voice in an ambient multi-speaker scenario with a patient. And then we can code it correctly according to federal guidelines in the US or the national health system in the UK or Canada. Then, we can compliance check it according to the program integrity compliance guidelines that health payer, government payer, private payer has. And then we can produce it to the end user clinician and tell them, you know, here’s how you bill your claim correctly. Here’s how you’re in the lanes or outside of them after we’ve told you what the coding is that you should use in your billing forms. And that’s the service we provide. We just use pure technology about 90% to do that successfully and accurately. That’s what we do.”
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