Clintegrity CAC Solutions

Transforming medical coding

Automatically read and translate electronic clinical documentation into the appropriate medical codes

The transition to ICD-10 medical coding standards will improve patient care in the long-term. However, with eight times the codes of ICD-9 and increased specificity, the standards will require a totally new way of coding in order for your health system to overcome productivity and financial challenges. Clintegrity CAC - Computer-Assisted Coding solutions, in combination with Nuance Healthcare’s market-leading Clintegrity Coding and Clintegrity Compliance solutions, harnesses the power of Nuance’s Clinical Understanding (CLU) engine by automatically reading and translating electronic clinical documentation provided by healthcare practitioners into the appropriate medical codes. Clintegrity CAC solutions automatically generate suggested ICD-9-CM, CPT, ICD-10-CM, and PCS medical codes for review and validation, which accelerates code submission to patient billing systems and leads to a better result. This next-generation coding solution completely automates what was previously a resource-intensive process requiring manual interpretation of clinical documentation and coding input prior to billing. Hospitals have reported that CAC solutions have increased coder productivity by more than 20 percent, while decreasing coder overtime by as much as 80 percent and decreasing external audit fees by as much as 50 percent.


The impact of the transition to ICD-10

With eight times the codes of ICD-9 and increased specificity, the standards will require a totally new way of coding in order for your health system to overcome productivity and financial challenges. Harness the power of Nuance’s Clinical Understanding (CLU) engine with Computer Assisted Coding by automatically reading and translating electronic clinical documentation provided by healthcare practitioners into the appropriate codes. Clintegrity CAC automatically generates suggested ICD-9-CM, CPT, ICD-10-CM, and PCS medical codes for review and validation.


Greater specificity and clinical detail

ICD-10-CM and PCS code sets incorporate greater specificity and clinical detail to provide information for clinical decision-making and outcomes research. This will impact virtually all providers of healthcare, including:

  • Physicians, clinicians, and nurses
  • Data managers, information systems, security, and technology personnel
  • Quality and utilization management personnel
  • Researchers and ancillary department personnel
  • Billing/accounting personnel
  • Compliance officers, auditors, and fraud investigators

Both ICD-10-CM and PCS code sets are more complex than the predecessor. From retraining the entire coding workforce to increased Accounts Receivable (AR) days, this update can drastically affect the productivity and day-to-day operations of any compliant U.S. healthcare organization.

Other critical business concerns include:

  • Productivity losses expected to range from 10% to 50%
  • Increased coding backlog and greater time requirements to assign codes
  • Increased Discharged Not Final Billed (DNFB) and AR days
  • Decreased ability to assign codes from memory
  • Increased anatomy, physiology, and medical terminology requirements
  • Coder shortages

Clintegrity CAC can help your organization mitigate anticipated productivity challenges due to the transition to ICD-10, while increasing accuracy and accelerating billing processes. Nuance Healthcare’s integrated coding solution, coupled with automated workflow and compliance editing, can ensure maximum productivity throughout all Health Information Management processes.


Features

This next-generation coding solution completely automates what was previously a resource-intensive process requiring manual interpretation of clinical documentation and coding input prior to billing. Hospitals have reported that CAC has increased coder productivity by more than 20 percent, while decreasing coder overtime by as much as 80 percent and decreasing external audit fees by as much as 50 percent.

Key Features
  • Leads to increased efficiency and data integrity by integrating seamlessly with the rest of the single-platform Clintegrity suite, which includes Coding and Compliance solutions.
  • Nuance’s patented CLU technology uses SNOMED CT, the most comprehensive, multilingual clinical healthcare terminology in the world. Nuance Healthcare is one of the first vendors to offer this.
  • Leverages existing Clintegrity hardware, software, and interface investments.

Point-of-entry program

The best way to get the record straight - right from the start

As more and more patients are admitted through your Emergency Department, accurate documentation is becoming critically important. Due to the complexity of ED cases, the hectic work environment and the need to make rapid decisions, in many cases patient acuity is inaccurately reflected by under-documentation of the patient's clinical situation. Staff may accurately document the injury that brought the patient in, but miss secondary diagnoses and/or pre-existing conditions. What's more, a problem list isn't usually created until the patient is moved onto the floor...if ever. Improving the quality of the clinical documentation promotes better communication and creates an opportunity to positively impact clinical outcomes.

Nuance has developed a powerful solution and a new clinical staff position to help you ensure better clinical outcomes and accurate reimbursement.

The solution: Clintegrity CDI Point of Entry Program

Because documentation of critical information starts in the Emergency Department, the Point of Entry program starts there too - evaluating the severity of illnesses, assessing present-on-admission (POA) conditions, determining patient status (observation or inpatient), ensuring compliance with quality core measures, creating a problem list at the point of entry, and enabling more accurate documentation. The Point of Entry program builds on the foundation of Clintegrity CDI; and takes it even further, providing comprehensive clinical integration management.

New role: Clinical Integration Specialist

With this new solution comes a new clinical role - the Clinical Integration Specialist (CIS). This individual works closely with your clinical team to ensure all clinical observations are documented appropriately from the ED to discharge.

Your CIS is trained to:
  • Perform hands-on patient assessments
  • Identify and secure documentation of POA conditions
  • Assist with quality indicators such as core measures and patient safety indicators
  • Establish a problem list at the point of entry
  • Facilitate accurate, compliant clinical documentation by providing concurrent support to physicians
  • Review medical records for completeness and accuracy
  • Maintain liaison with ED and inpatient case manager and CDS
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