With the healthcare policy changes of the past decade, payers such as Medicare and other health insurance companies have shifted financial responsibility towards hospitals. For instance, many insurance companies no longer pay for readmission following discharges. Thus, if patients return for a similar complication within a given time frame after discharge, hospitals and patients are left with the costs for extra inpatient stays.
Consequently, hospitals have been aligning themselves with post-acute care facilities. This ensures that patients who do not require hospital care can still receive appropriate transitional care during recovery. These facilities include inpatient rehab, home health agencies and nursing facilities, as well as long term hospitals. Here, patients have access to trained medical personnel to assist in the transition from hospital to home. Ideally, this may prevent readmission by monitoring changes in condition, lessening the financial responsibility for hospitals while simultaneously improving patient recovery outcomes.
Artificial intelligence and machine learning has numerous applications in regards to post acute care, which focus on improving workflow while promoting better patient outcomes. This allows patients to take a larger role in their own treatment and wellness.
Remote monitoring tools and smartphone programs can live update electronic medical records and provide additional diagnostic data including real time EKG and other vital signs prior to hospitalization and during post-acute care. By generating their own health data to share with corresponding caregivers ensures that individual-specific needs are met.
DocCharge takes the time to assess different technologies and AI based solutions to ensure that both provider and patient needs are being met during the charge capture process and documentation process.
AI from the DocCharge Perspective
DocCharge is developing an AI technology based platform to improve coding specificity within the mobile application and portal. The goal is to deliver medical necessity information and provide a utilization guideline to physicians and coders prior to submitting the claim. This ensures reduction of denials and improved revenue for the practice.