Healthcare providers in the United States spend a lot of time on administrative tasks instead of treating patients. A Medscape report found that 58% of doctors think paperwork hurts the quality of patient care. The Mayo Clinic says up to 63% of doctors feel burned out. Much of this stress comes from entering data into electronic health records, writing clinical notes, and dealing with prior authorizations.
Manual work for documentation, coding, and authorizations wastes time. Doctors often spend hours on electronic health record tasks rather than with patients. These delays can slow down billing, reduce money collected, and increase risk of errors or missing codes.
For administrators and IT managers, using different systems for documentation, coding, and prior authorizations makes work harder. Separate systems cause data to be stored in silos. This makes audits harder and raises IT costs.
When documentation, coding, and authorizations are done in different systems, the process becomes broken up. Research from ACCC Health and Cohere Health shows that combining these parts lets experts work together in real time.
This reduces back-and-forth questions and speeds coding, which helps payments come faster. For example, AGS Health helps almost half of the top 20 U.S. hospitals work smoothly on one platform. Bringing workflows together lowers mistakes and repeated work, making results more consistent.
Healthcare providers save time usually spent moving data between systems. This saved time can be used to care for patients better and lowers doctor burnout. Onpoint Healthcare’s IRIS system lets doctors save over three hours each week by automatically creating clinical notes.
Computer-Assisted Coding (CAC) and Clinical Documentation Improvement (CDI) help make notes and codes more accurate. CAC looks at clinical notes and assigns the right codes automatically. CDI makes sure notes are complete and correct.
A single platform that combines CAC and CDI lets specialists get involved earlier, during patient admission. This ensures notes show how serious the illness really is and the care given. This is very important for correct Diagnosis-Related Group (DRG) coding and getting the right payment.
Better coding lowers denial rates because questions and audit risks go down when notes and codes match the care provided. This is very important in the U.S. where payment depends a lot on good documentation. Health systems using Commure’s Autonomous Coding saw an 83% drop in time clinicians spent entering charges and were able to auto-code over 85% of charges, speeding up billing and making it more accurate.
Healthcare organizations must follow strict rules like HIPAA and CMS policies. Platforms with audit tools and compliance checks keep documentation safe and help meet regulations.
Unified systems help find problems early, which lowers the chance of audits later. Some systems track all changes to documentation and coding in real time, keeping records that can’t be changed, as rules require.
With timely and accurate notes, healthcare groups face fewer denials and delays from compliance issues. This lowers financial risks and reduces extra paperwork, especially since CMS wants more transparency and faster claims.
Prior authorization (PA) often slows down healthcare in the U.S. Manual PA takes a lot of staff and doctor time. This leads to burnout and delayed care. AI-powered prior authorization automation cuts down repetitive data entry and reduces mistakes in requests.
Cohere Health uses AI clinical decision tools that put guidelines inside provider workflows. By automating PA requests, checking them in real time, and giving alerts for missing info, the platform speeds up approvals and makes results more consistent across payers.
This automation cuts down delays and lowers claim denials caused by waiting for approvals. Keeping PA with coding and documentation on one system makes communication smooth and improves workflow.
Onpoint Healthcare’s IRIS system uses AI to capture patient visits without doctors needing to type or edit notes. This saves lots of documentation time and lets doctors spend more than three extra hours a week caring for patients instead of writing notes.
Commure’s Ambient AI works with over 60 electronic health record systems and cuts daily note-taking time by 30 to 90 minutes. It listens to doctor-patient conversations and makes clinical notes automatically inside existing workflows. This helps doctors in many fields, from heart care to family medicine, use AI without big interruptions.
AI has changed coding by making systems that create correct CPT and ICD-10 codes from clinical notes. Tools like Commure’s Autonomous Coding speed up coding by over 80%, improve accuracy, and help with billing rules.
This automation frees staff from entering charges manually and lowers coding mistakes, denials, and missed billing. This helps the financial side of healthcare, which is often complex in the U.S.
AI tools like those from Cohere Health use machine learning and language understanding to review clinical data and handle prior authorization decisions. These tools check authorizations against current clinical guidelines, like those from the American Academy of Orthopaedic Surgeons, with little human help.
AI alerts remind providers to complete authorization requests correctly, reducing mistakes and re-submissions. APIs using data standards such as FHIR let providers and payers share data in real time.
Automating and combining prior authorization with clinical and billing workflows helps patients get care faster. It cuts administrative delays and supports fairness in healthcare by removing manual hurdles in places with fewer resources.
Choosing integrated platforms for documentation, coding, and authorizations needs careful thought. Healthcare managers should check if systems work well with current electronic health records, meet rules, and can be adjusted to fit their practice.
Training and education are key to use AI tools well without interrupting work. Also, protecting patient data privacy and security must remain a high priority.
Hospital and clinic administrators, owners, and IT managers in the U.S. are increasingly seeing the value of unified platforms that bring together documentation, coding, and prior authorizations. These systems use AI and automation to simplify complex workflows, cut costs, improve coding accuracy, and boost compliance. Using these technology tools can help healthcare groups run better, make providers happier, and support good patient care.
The IRIS platform aims to reduce administrative burdens on physicians, alleviate physician burnout, and enhance overall productivity in healthcare systems by automating clinical documentation and integrating various clinical processes.
By automating clinical documentation and simplifying workflows, the IRIS platform significantly reduces the time physicians spend on EHR-related tasks, thereby allowing them to focus more on patient care and less on administrative duties.
Up to 63% of physicians report experiencing burnout, largely due to administrative tasks and inefficiencies in healthcare workflows.
The platform employs a blend of artificial and clinical intelligence to produce accurate clinical notes automatically, allowing physicians to spend more time on patient engagement and less on documentation.
Onpoint Healthcare launched during the pandemic, where the industry focused on treatment and security, but it overcame these challenges by emphasizing the need for solutions to operational inefficiencies exacerbated by EHR adoption.
The IRIS platform features ambient clinical documentation, which allows physicians to engage with the technology seamlessly without acting as typists or editors, enhancing accuracy and compliance.
Compliance ensures that patient data is handled securely and meets the regulatory requirements, a key consideration for healthcare organizations to protect sensitive information.
The global healthcare technology market is expected to grow by 9.5% in 2024, reaching $265.2 billion in constant currency.
By integrating various aspects of clinical documentation such as coding, referrals, and prior authorizations into a single platform, it streamlines processes that often create bottlenecks, thereby enhancing efficiency.
Onpoint Healthcare aims to leverage innovative technology to deliver measurable results, enhancing efficiency, reducing admin burdens, and enabling healthcare providers to focus on high-quality patient care.
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