In the face of medical coder shortages and burnout, Maverick Medical AI is dedicated to revolutionizing the healthcare industry. Research highlights a projected 7% annual growth in demand for medical coders, while a current 30% workforce shortage exacerbates the challenges faced. These shortages have far-reaching negative consequences, including increased claim denials, revenue delays, and inaccurate coding practices.
To tackle these administrative burdens, the implementation of AI-driven solutions presents an exciting opportunity. While many Healthcare Executives recognize the potential of AI, it is crucial to acknowledge that not all autonomous medical coding solutions are created equal in terms of accuracy and performance.
In the early days of medical coding, the process heavily relied on manual intervention and expertise. As technology advanced, rule-based systems emerged as a solution to automate certain aspects of coding. These systems utilized predefined rules and algorithms, aiming to streamline the coding process. However, they had limitations, including the need for extensive manual rule development and a lack of adaptability to handle complex and evolving coding scenarios.
The introduction of machine learning algorithms brought a significant shift in medical coding technology. These algorithms leveraged data to learn patterns and relationships, allowing for more automated and accurate coding. Nevertheless, human experts were still required to manually extract relevant data for these machine learning models.
At Maverick Medical AI, our cutting-edge technology harnesses the power of clinical language models, deep learning techniques such as Generative AI, and Generative Pre-trained Transformers (GPT). These advancements enable accurate and efficient coding of unstructured text, exceeding a remarkable 85% direct-to-bill rate and an exceptional accuracy rate of 97% upon implementation. Our commitment to pushing the boundaries of innovation sets us apart in the market.
How do we accomplish this?
Let’s shed a light on our remarkable technology stack.
By employing an ensemble architecture, we merge numerous models, specifically deep learning AI networks proficient in discerning patterns and excelling at various tasks, along with other algorithms. This approach harnesses the strengths of diverse models with the objective of enhancing the overall performance and adaptability of the system. Medical Coding is ideal for this architecture, where it can truly excel in accomplishing these tasks.
Developing a medical coding language model required a significant amount of effort to tune and adapt existing toolkits, incorporating our medical coding expertise and specialized models specific to the task. This has allowed us to customize, adjust, and enhance the technology according to our unique coding expertise.
Other language models cannot do this. ChatGPT, for instance, does not inherently solve the problem at hand. While ChatGPT is a powerful language model, it is not a medical coding platform. It has limited ability to generate accurate medical codes as it may not have the most current coding information nor does it understand the nuances of the practices, payors, and regulations. What point would there be to using ChatGPT in its current form for the purposes of medical coding, when the goal is to increase accuracy and reduce reliance on human coders in short supply and such high demand? The degree of auditing necessary would actually become an increased burden to coders.
Maverick’s autonomous medical coding AI engine is trained on a vast dataset of medical codes, enabling it to comprehend the intricate and dynamic rules and regulations governing our industry.
For effective machine learning, a substantial volume of consistent, accurate, and up-to-date data is required to train the system. Even the most exceptional providers with well-established workflows and practices may face challenges in maintaining data consistency and keeping it updated with the latest regulations over time.
The Maverick algorithm uses various sampling testing and techniques in machine learning to ensure that we are able to train the model with minimal human interaction and to iteratively improve it.
Understanding the provider’s historical data has been the success of Maverick’s achievement of 85% direct-to-bill rate at go-live.
As we all know, garbage in is garbage out. During implementation, large amounts of claims data, along with the reports, are analyzed and validated. Any coding quality issues are identified and corrected prior to go-live. And learning from historical data means no countless hours spent starting from scratch to rebuild coding rules.
Breaking the coding barrier
Maverick employs advanced techniques to address scenarios with limited data. One such approach is the utilization of Generative AI models, which enable the generation of synthetic data resembling real-world examples. This synthetic data creation process allows Maverick to augment the available data and continuously enhance the system’s performance.
Additionally, Maverick utilizes transfer learning, a technique that leverages knowledge gained from pre-trained models on related tasks. By fine-tuning the pre-trained models using specific medical coding data, Maverick ensures consistent training and further refines the system’s accuracy in assigning appropriate codes.
By combining Generative AI for synthetic data generation and transfer learning for fine-tuning, Maverick optimizes the performance of its medical coding system, even in scenarios with limited data. This groundbreaking approach empowers Maverick to attain exceptional coding accuracy, enhances the overall efficiency of medical coding processes, and is the key factor behind our ability to achieve a guaranteed direct-to-bill rate of 85% upon go-live.
Maverick is leading the market!!!
Maverick is continuously setting new benchmarks in accuracy, adaptability, and efficiency in the realm of medical coding. Our advanced solutions not only yield highly precise codes, surpassing 97% accuracy, but also fulfill the rigorous requirements of payors and regulatory agencies. With a guaranteed 85% direct-to-bill rate upon go-live, Maverick is redefining industry standards today and for the foreseeable future.