Can we innovate medical billing and record keeping?

Ghauri said the company is “working to solve the national multi-billion dollar problem of medical billing inefficiency.”

Q: How does Codified Health work?

ghauri: Codified Health provides a medical code recommendation system, a documentation verification tool, and interoperable software that works with all existing Electronic Health Record System (EPD) platforms. We make sure claims are filed quickly with faster payments, consistent compliance, and billing transparency. It is easy to use and the system can produce the codes needed for reimbursement, confirm that the patient card contains the necessary documentation for each medical code and healthcare provider, and recommend additional medical codes (along with other documentation) to include.

How does Codified Health benefit patients?

Our tool ensures more transparent invoicing. With our platform we prevent over- and under-billing of patients. This allows patients to be charged only what is correct for their visit.

Codified Health is a medical billing company powered by artificial intelligence. It was founded by four students.Codified Health

How could a system like Codified Health relieve the pressure on hospital systems and their employees?

Burnout among physicians – which can be exacerbated by the complexity of medical codes – results in high management costs and errors. Our company can help physicians save money by billing more effectively while reducing the amount of time it takes to enter data.

Through our research, we found that the majority of billing errors are caused by avoidable errors and inefficiencies. These errors have resulted in an average administrative burden index of $2.36 per claim for both insurers and physicians. But doctors lose thousands in reimbursement claims due to downcoding, and upcoding results in billions of dollars in excess government spending. Instead, we can ensure that patients are charged the exact amount.

Cyber ​​attacks on hospital systems are on the rise. How do you ensure these records are protected?

We are very aware of the sensitivity of medical data and take all possible measures to ensure that it is not leaked or stolen. We use secure, encrypted communications to transmit sanitized and anonymized data to minimize points of failure for data leaks.

How would you make billing information more transparent?

A private practice produces tons of data, much of which can be captured at the billing stage. We provide personalized data summaries for practices so providers find the information they want in the blink of an eye. By making the billing process accurate, easy and faster, healthcare providers have more time to focus on their patients. We also plan to extend the Codified Health system to audits to prevent instances of over-cost in Medicare claims.

Have you already worked with clinics, doctor’s offices or hospitals to implement Codified Health in their daily use?

We partner with clinics from a number of specialties, including pediatrics, gynaecology and ophthalmology. They generously provided us with their anonymized EHR data to fine-tune our AI. We plan to begin our beta tester trial run in September of this year. Our goal is to make billing easier for private practices across the country by early 2023.

Do you have investors or have you raised money so far?

Our startup has received $12,000 as a result of our acceptance into this summer’s cohort on Brown’s B-Lab (which is a flagship accelerator program for young entrepreneurs working on high-impact ventures). Over the next eight weeks, we’ll be networking with potential investors and venture capitalists with the goal of opening our first investment round in August. (Those interested in investing can: Contact the founders.)

How does this platform differ from what is already on the market?

Currently, the main competitors for us are human coders who use a portion of the revenue to come up with the right codes for the doctor. By creating an autonomous process for coding, we can provide our service without taking a percentage of the turnover.

How much does Codified Health cost to use?

Our pricing model helps doctors save in two ways. First, through the use of artificial intelligence, our services will help physicians save on the labor costs required to otherwise hire an employee to perform internal billing or outsource to external billing. Second, because our AI is trained to verify the documentation insurance companies require for each code, our billing services are more accurate than standard agents.

By minimizing billing errors, physicians can focus primarily on their patients instead of being distracted by under-billing or Medicare/Medicaid penalties for incorrect billing. In addition, we plan to charge a fixed monthly rate per practitioner rather than per patient, resulting in predictable and non-variable costs.

The Boston Globe’s weekly Ocean State Innovators column features a Q&A featuring Rhode Island innovators starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Alexa Gagosz at [email protected]

Alexa Gagosz can be reached at: [email protected]† Follow her on Twitter @alexagagosz and on Instagram @AlexaGagosz

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