Automated revenue discovery for primary care
A primary care provider traded manual chart audits for autonomous coding and revenue discovery, resulting in 5x ROI.
Primary care
Provider
athenahealth
Undercoded notes were causing revenue leaks
Charta found that 12% of the provider's encounter notes contained underleveled E/M codes.
This primary care provider already had a system for attempting to close revenue leaks: an offshore team of medical coders reviewed provider documentation to code all their notes for them. A medical coder focused on QA audited a portion of the charts to ensure the team was capturing charge accurately and fully.
But the system clearly wasn’t working: the provider suspected revenue leaks were still making it through this time-consuming and expensive process, which relied heavily on manual charge capture and added seven days to the billing cycle. A suspected culprit for the leak was E/M leveling, which the offshore team had no structured process for reviewing and validating.
Charta analyzed a sample of the provider’s charts and found that at least 12% contained underleveled E/M codes.
Fully autonomous coding and revenue discovery
Manual audits of a small sample of charts were replaced with autonomous review of 100% of encounter notes.
By replacing a human coder who could only review a small portion of charts with autonomous coding and targeted chart review for revenue discovery across all patient encounters, the provider was able to refocus its offshore team on documentation quality, shifting E/M leveling and CPT coding decisions to Charta for 100% pre-billing compliance and revenue integrity.
Revenue uplift and faster times to resolution
The practice achieved a 5x ROI by implementing Charta.
Charta for autonomous coding and revenue discovery delivered a 5x return on investment by eliminating the revenue leak associated with missing and undercoded notes.
In addition to the financial return on investment, the practice gained access to comprehensive data insights into provider performance on coding and clinical compliance, delivered through data dashboards custom designed for their clinical leadership.