Define the evaluation
An evaluation design and repeatable scoring process, with clear definitions of the reference labels and metrics.
Understand coding performance, denial patterns, and the financial implications of model changes. We work with audited cases and claims to assess accuracy, investigate errors, and identify where process or technology changes may help.
Book a revenue-cycle reviewCompare model configurations against reviewed cases, examine errors by specialty and code, and document the limits of each comparison.
Organize payer explanations and claims history into patterns your team can investigate. Review recurring causes and the records behind each category.
Estimate the value of coding and workflow changes using encounter volume, payer mix, and reimbursement assumptions.
An evaluation design and repeatable scoring process, with clear definitions of the reference labels and metrics.
Analysis of overcoding, undercoding, and recurring error patterns.
Comparisons of model, prompt, terminology, and rules-based approaches where relevant.
Claims-based financial estimates with assumptions and sensitivity analysis.
For a clinical-documentation technology company, we developed recurring coding-performance analysis using audited cases and claims, assessed model changes and financial value across specialties, and tested a rules-based alternative for parts of code selection. The evaluation gave the team a repeatable way to compare configurations and examine the errors that mattered to practices.
Bring a performance question, a recurring error pattern, or a proposed model change.