Health tech company Iodine Software and coding software platform TruCode are collaborating to upend clinical administration using artificial intelligence.
Austin, Texas-based Iodine Software developed artificial intelligence-powered software solutions to address automation for clinical administration and revenue cycle management. The company's AwareCDI Suite identifies and captures mid-revenue cycle leakages, like discrepancies in reimbursement and clinical documentation, to make sure healthcare services are accurately coded and to optimize revenues.
Through the partnership, Iodine Software will integrate TruCode's coding resources directly into its AwareCDI suite. The combined solutions will provide clinical documentation improvement teams with easy access to detailed diagnosis and procedure code reference information directly in their workflows, in addition to access to complete official code books, according to the company.
The technology will help support accurate capture of documentation and code assignment resulting in appropriate claim reimbursement, accurate reporting of patient outcomes and reduced claims denials, according to the companies.
“Clinical documentation improvement is one of the most important areas of hospital operations and has a direct impact on both revenue performance and clinical quality," said William Chan, Iodine Software co-founder and CEO. "However, it often requires healthcare professionals to complete complex and tedious work that can negatively impact organizational performance."
Accurate and efficient medical coding is critical for a hospital's revenue cycle performance. But healthcare organizations face challenges with RCM processes due to coding errors as well as a shortage of experienced coders and lack of complete clinical documentation, according to Chris Fowler, CEO of CPSI. The healthcare solutions company acquired TruCode in 2021.
Frequent regulatory changes and changes to coding guidelines further complicate the coding process, Fowler said.
An estimated 84% of healthcare leaders believe that a root cause of lost or decreased revenue is inaccurate clinical documentation and coding, which can cost the average hospital $5 to $10 million for the average 250-bed hospital in revenue leakage, according to Iodine Software's data.
By integrating AI and coding software directly into a CDI team’s workflow, provider organizations can capture earned revenue and minimize physician burnout caused by documentation and coding processes, Chan said.
Technology can play an important role in helping healthcare organizations overcome clinical documentation challenges, Fowler said. "Encoders like TruCode alert coders regarding potential errors, helping to ensure complete and accurate code assignment, which can lead to a reduction in claim denials. TruCode also provides all relevant coding references as the health information professional works, helping to ensure that the latest coding guidelines are applied," he said.
A major player in healthcare artificial intelligence, Iodine is a large clinical AI engine used by more than 800 health systems and 80,000 physicians. The company, which was founded in 2010, experienced rapid growth over the last decade by applying its machine learning engine to solve midcycle revenue leakage—a problem that costs healthcare systems billions in lost revenue due to resource-intensive, highly manual clinical documentation workflows.
While Iodine's machine learning approach initially focused on solving things like clinical documentation improvement, Iodine has recently picked up other tech companies to build out its AI platform and broaden its market reach.
In May 2021, Iodine snapped up Artifact Health to get its AI technology directly into the hands of more than 80,000 providers across the country. Last June the company bought competitor ChartWise Medical Systems.
TruCode previously partnered with ChartWise CDI prior to the Iodine acquisition and targeted its combined software to smaller hospitals. Fowler said that the new collaboration with Iodine expands the companies' combined reach up-market to the larger health systems.
The partnership between Iodine Software and TruCode will arm administrative teams with better tools and resources, according to Chan. Embedding TruCode's coding software into Iodine Software's AI engine enables CDI professionals to review the clinical documentation and ensure it meets criteria for appropriate reimbursement.
Last December private equity firm Advent International bought a significant stake in Iodine Software, valuing the company at more than $1 billion.