XpertCoding

XpertCoding automatically codes clinical encounters into CPT and ICD-10 claims for healthcare providers, speeding claim submission and reducing coding workload.

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Overview

XpertCoding reads clinical text from the EHR or EMR and assigns CPT and ICD-10 codes, including Category II quality codes, with minimal human supervision. A claim scrubber, which can be customized to payer-specific rules, prepares claims for automated submission, and claims flagged for manual review are shown in the Business Intelligence platform. The platform provides dashboards for claims, providers, clinical documentation improvement, risk adjustment (HCC) and quality measures, plus an audit trail of changes made by the coding engine. EHR connections use RPA, API integrations, HL7-ADT messaging or SMART on FHIR, and the vendor states that no IT support is required from the client.
More product details

Who it is for

Industries
  • Healthcare

Product

Solution Kind
Application

Features

Claims Management

Dashboard of all claims coded by XpertDox

Automated claim submission

More details & conditions: Claims Management

Monitoring of claims flagged for manual review with hold-reason insights

Categories: Medical Billing · Revenue Cycle Management

Code & Charge Entry

Automated CPT and ICD-10 coding

Category II CPT quality coding

More details & conditions: Code & Charge Entry

Charge capture and recovery of missed charges on previously submitted claims

Categories: Medical Billing

Compliance Tracking

HIPAA-compliant audit trail of modifications made by the coding engine

Categories: Medical Billing

Machine Learning

Hybrid AI coding engine combining ensemble models, neural networks and symbolic reasoning with payor guidelines

Categories: Artificial Intelligence

Natural Language Processing

Natural language processing of clinical text to assign medical codes

Categories: Artificial Intelligence

Workflow Automation

Automated coding of clinical encounters

Automated claim submission and claim posting in the EHR

Categories: Artificial Intelligence

Data Extraction

Extraction of clinical data from EHR/EMR systems for coding and claim posting

Categories: Artificial Intelligence

Multiple Data Sources

Extraction of encounter data from EHR/EMR systems via RPA, API integrations, HL7-ADT messaging or SMART on FHIR

Categories: Artificial Intelligence

Medical Billing

Automated medical billing aligned with payor-specific contracts

Daily automated claim submission

Categories: Revenue Cycle Management

Revenue Management

Revenue cycle dashboard with key performance metrics

Level-of-billing and charge-capture optimization

Categories: Revenue Cycle Management

EHR/EMR Integration

Connections via RPA, API integrations, HL7-ADT messaging or SMART on FHIR

Implementation with NextGen, eClinicalWorks, Athenahealth, Experity, ModMed, Epic and other EHR/EMR systems

Categories: Revenue Cycle Management

Technical details

Implementation

Delivery Mode
  • Vendor
Typical Duration
Unit
Weeks
Scope
EHR connection timeline: under 1 week for eClinicalWorks, Athenahealth and Experity; under 4 weeks for NextGen, ModMed and Epic; 6-8 weeks for other or custom EHR/EMR systems.
Maximum
8
Estimate kind
Vendor estimate

AI

Human Approval
  • Selected actions
Input Modalities
  • Text
Output Modalities
  • Structured data

Security

Assurances
  • Kind
    Certification
    Scope
    XpertDox information security management
    Standard
    ISO/IEC 27001
  • Kind
    Certification
    Scope
    XpertDox business continuity management system
    Standard
    ISO/IEC 22301
  • Kind
    Attestation
    Scope
    Data security, availability, confidentiality and privacy
    Standard
    SOC 2 Type 2
  • Kind
    Self declaration
    Scope
    Processing, maintenance and storage of protected health information
    Standard
    HIPAA
Audit Events
  • Data changes

Support

Channels
  • Ticket

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