Artificial Intelligence (AI) is making a significant impact on healthcare coding, streamlining workflows and improving accuracy. However, as Dawson Ballard, a coding auditor and educator at Rush University Medical Center, recently discussed with Becker’s Hospital Review, AI coding platforms require careful evaluation. While they can enhance productivity, they are not foolproof and should always involve human oversight.

At ForeSee Medical, we understand that selecting an AI-powered risk adjustment solution is a critical decision for healthcare organizations. That’s why our platform is designed not only to improve efficiency in HCC coding but also to provide comprehensive supporting documentation to ensure compliance and accuracy. Here’s how AI, when implemented correctly, can reshape medical coding and how ForeSee Medical’s solution aligns with industry best practices.

Coders Must Be Involved in AI Selection

One of Mr. Ballard’s key insights is that coders must play a central role in selecting an AI platform. As the primary users, coders should have the opportunity to evaluate demos, ask questions, and ensure the system aligns with their workflow needs.

At ForeSee Medical, we built our AI-powered risk adjustment platform with coders in mind. We collaborated with experienced coding professionals to develop an intuitive system that enhances, rather than replaces, their expertise. Our software provides coders with AI-driven suggestions while allowing them to validate and refine the codes before submission, maintaining the essential human touch in the process.

Vendor Transparency is Critical

Mr. Ballard also cautioned against vendors who lack direct coding experience. Some AI platforms are developed without the input of coding professionals, leading to errors and inefficiencies. Organizations should ask vendors about their development process and whether coders were involved from the beginning.

ForeSee Medical takes transparency seriously. Our AI platform was developed in collaboration with coding experts, ensuring that it understands the nuances of HCC coding. Additionally, our solution offers robust audit trails and detailed documentation to support every coded diagnosis, helping providers substantiate their risk adjustment efforts.

Conduct Thorough Vendor Research

Another key takeaway from Mr. Ballard’s interview is the importance of vetting AI vendors before committing. He recounted instances where healthcare organizations nearly signed contracts with vendors, only to discover financial or legal issues later in the process.

ForeSee Medical encourages prospective clients to conduct thorough due diligence. We welcome organizations to read our client testimonials, review case studies, and examine our track record. Our goal is to be a trusted partner in achieving risk adjustment accuracy, providing solutions that stand up to scrutiny and deliver measurable value.

Privacy and Security Should Be a Top Priority

AI coding platforms must integrate securely with electronic medical records (EMRs) while protecting patient data. Mr. Ballard emphasized the need to ask vendors about their security safeguards.

ForeSee Medical prioritizes data security, implementing robust encryption, access controls, and compliance measures to protect sensitive health information. Our platform meets HIPAA and HITRUST security standards, ensuring that healthcare organizations can trust their data is safeguarded against breaches and unauthorized access.

AI is a Tool, Not a Replacement for Coders

While AI can enhance computer assisted coding accuracy and efficiency, Mr. Ballard reminds healthcare organizations that it should not replace human coders entirely. AI-generated codes still require review and validation to ensure compliance and accuracy.

ForeSee Medical’s AI-powered HCC coding software is designed to assist coders, not replace them. Our platform analyzes clinical documentation, suggests relevant HCC codes, and provides supporting evidence, allowing coders to make informed decisions. This ensures accuracy while maintaining compliance with CMS guidelines.

Moving Forward

As AI continues to reshape healthcare coding, organizations must approach adoption strategically. Mr. Ballard’s insights reinforce the need for careful vendor selection, coder involvement, and a strong focus on security and compliance.

ForeSee Medical’s AI-powered risk adjustment platform aligns with these best practices, offering an intelligent, coder-friendly solution that enhances productivity while ensuring accuracy. By leveraging AI with human oversight, healthcare organizations can optimize their coding processes, reduce compliance risks, and improve financial outcomes.

Interested in learning more about how ForeSee Medical can transform your HCC coding processes? Contact us today for a demo and see AI-driven coding in action.

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Blog by The ForeSee Medical Team

Choosing the Right AI Coding Platform: Insights from Becker’s Healthcare