Hierarchical Condition Category (HCC) coding plays a pivotal role in federally regulated risk adjustment payment models, ensuring accurate reimbursement for health insurance plans and better care for managed populations. Providers are essential in this process, as effective collaboration with health plans leads to improved patient outcomes. Traditionally, electronic medical records (EMRs) served primarily as data repositories, but technological advancements, particularly in Natural Language Processing (NLP), have transformed their utility.This presentation will explore how WVU Medicine has harnessed unstructured patient data within their EMR system to accurately assess and assign HCC codes. By leveraging NLP models from John Snow Labs, WVU Medicine was able to identify and extract relevant HCC codes from clinical notes, subsequently providing these codes to physicians through best practice alerts. This innovative approach has significantly streamlined HCC coding, reducing the burden on providers while enhancing the accuracy and efficiency of the process.
Hierarchical Condition Category (HCC) coding plays a pivotal role in federally regulated risk adjustment payment models, ensuring accurate reimbursement for health insurance plans and better care for managed populations. Providers...
There is overwhelming evidence from academic research and industry benchmarks that domain-specific and task-specific large language models outperform general-purpose LLMs across multiple dimensions: Accuracy, veracity, human preference, and cost. This...
Clinical data summarization using generative AI involves leveraging advanced algorithms to extract, analyze, and condense vast amounts of medical information into concise, actionable insights. This technology employs natural language processing...
In this speech, I will provide an overview of the current challenges faced by healthcare professionals in accessing and interpreting vast amounts of patient data. I will discuss how our...
Clinical decision making is often based on analysis of retrospective patient cohorts to enable and guide treatment decisions. In general, there are large volumes of data within hospitals within Electronic...