Large Group Physician Practice Computer Assisted Coding for Professionals: Market Shares, Strategies, and Forecasts, Worldwide, 2017 to 2023

  • ID: 4231950
  • Report
  • Region: Global
  • 243 Pages
  • Wintergreen Research, Inc
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The Worldwide Market for Large Group Physician Practice Computer Assisted Coding at $323 Million in 2016, is Anticipated to Reach $1.1 Billion by 2023

FEATURED COMPANIES

  • 3M
  • Craneware
  • EPIC
  • M*Modal
  • Nuance
  • Quest Diagnostics
  • MORE

Large physician practices seek next generation computer assisted coding to support further automation of the billing process and use of analytics to achieve higher and faster payments for services rendered. The study has 243 pages and 82 tables and figures.

Large physician office computer assisted coding of medical information uses natural language solutions to link the physician notes in an electronic patient record to the codes used for billing Medicare, Medicaid, and private insurance companies.

Physician Practice Professionals and Ambulatory Treatment Centers Use Computer Assisted Coding Systems To Streamline ICD-10.

Large group physician practices use computer assisted coding as part of larger automated systems. Computer assisted coding of medical information can link the physician notes in an electronic patient record to the codes used for billing Medicare, Medicaid, and private insurance companies. This creates improved operations for a group practice office.

88% of the coding can occur automatically without human review. Physicians are more comfortable describing a patient treatment in words. The electronic patient record, created using physician dictation, is used to form the base for the coding. The physician dictation done using regular language that the software recognizes and translates into billing codes is an automation that all offices need. Penetration of high end systems that are needed is very low now.

Physicians think about patient conditions in terms of words. CAC software is configured to achieve working with physicians who are more comfortable describing a patient treatment in words than codes. The electronic patient record, created using physician dictation, is used to form the base for the coding. Natural language solutions implement computer coding to identify key words and patterns of language. The physician dictation can be done using regular language that the software recognizes and translates into billing codes.

According to Susan Eustis, lead author of the team that prepared the study, “Growing acceptance of computer assisted coding for physician offices represents a shift to cloud computing and billing by the procedure coded. Because SaaS based CAC provides an improvement over current coding techniques the value is being recognized. Administrators are realizing the benefits as related to the quality of office billing systems.”

The worldwide market for large group physician practice computer assisted coding at $323 million in 2016, is anticipated to reach $1.1 billion by 2023. The complete report provides a comprehensive analysis of Large Group Physician Practice Computer Assisted Coding in different categories, illustrating the diversity of software market segments. A complete procedure analysis is done, looking at numbers of procedures and doing penetration analysis.

Major health plans report a smooth transition to ICD-10. This is due to rigorous testing for six years. ICD-10 has had a positive impact on reimbursement. ICD-10 coding system requires use of 72,000 procedure codes and 68,000 CM codes, as opposed to the 4,000 and 14,000 in the ICD-9 system. Managing high volume of codes requires automation. Healthcare providers and payers use complex coding systems, which drives demand for technologically advanced CAC systems.

The market for computer-assisted coding grows because it provides management of workflow process value by encouraging increasing efficiency in care delivery for large professional physician practices and ambulatory clinical facilities. By making more granular demarcation of diagnoses and care provided for each diagnosis, greater visibility into the care delivery system is provided. Greater visibility brings more ability to adapt the system to successful treatments.

Key Topics:

  • Natural Language Coding
  • NLC
  • Computer Assisted Coding
  • CAC
  • Rules Based Coding Technology
  • Medical Coding
  • Medical Necessity
  • Electronic Medical Record
  • Electronic Medical Coding
  • Natural language solutions
  • Computerized medical workflow
  • Claims scrubbers
  • Tessi® (terminology supported semantic indexing)
  • Electronic coding for physicians
  • Medical necessity
  • Correct coding tools
  • Physician electronic medical record (emr) systems
  • Language and computing
  • Ontology assisted solutions
  • Diagnosis codes
  • Procedure codes
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FEATURED COMPANIES

  • 3M
  • Craneware
  • EPIC
  • M*Modal
  • Nuance
  • Quest Diagnostics
  • MORE

Large Group Physician Practice Computer Assisted Coding Executive Summary

  • Medical Best Practice Linking
  • CAC for Coders
  • Computer Assisted Coding Best Practice
  • Coding Solutions
  • Physician Computer Assisted Coding Services
  • Natural Language Computer Assisted Coding Market Shares
  • Natural Language Computer Assisted Coding of Medical Procedures Forecasts
  • Medical Best Practice Linking

1. Large Physician Practice and Ambulatory Treatment Center Computer Assisted Coding Market Description and Market Dynamics
1.1 Physician Office Coding Challenge
1.1.1 Physician Practice Services Component of Computer Assisted Coding (CAC)
1.1.2 Advances In Natural Language Processing And Informatics
1.1.3 Using Electronic Health Record (EHR) Documentation To Generate Codes for Large Physician Offices
1.2 Computer-Assisted Coding
1.2.1 Physician Practice Industry Forces Affecting Development of CAC
1.2.2 Application of CAC Technology In Large Physician Offices
1.3 Development of a CAC Tool For Physician Use
1.3.1 Large Physician Office CAC Impact on the Coding Workflow
1.3.2 Computers Replace Human Coders
1.3.3 CAC Applied Without Human Intervention Depends On Critical Differences Between CAC Systems
1.4 Healthcare Industry Largest In United States
1.4.1 Building a Safer Health System
1.4.2 Facilitating the Use of Technology in the Healthcare Industry
1.4.3 Prescription Drug Modernization
1.5 Medical Necessity and Medical Necessity Errors
1.6 Physician Office Electronic Coding
1.6.1 CAC Automates and Accelerates Auditing
1.7 Natural Language Solutions
1.7.1 State Of Language Technology Evaluation
1.8 Computerized Workflow System
1.8.1 Confidence Assessment Module
1.8.2 Researching Electronic Coding Products:

2. Professional Large Physician Office Computer Assisted Coding Market Shares and Forecasts
2.1.1 Physician Practices With A Services Component Market Driving Forces
2.1.2 Medical Best Practice Linking
2.1.3 Large Physician Office CAC for Coders
2.1.4 Large Physician Office Computer Assisted Coding Best Practice
2.1.5 Large Physician Office Computer Assisted Coding Medical Information Solutions
2.1.6 Large Physician Office Coding Solutions
2.1.7 Physician Computer Assisted Coding Services
2.2 Physician Office and Ambulatory Clinical Organizations Natural Language Computer Assisted Coding Market Shares
2.2.1 Optum
2.2.2 Optum Automated Code Identification
2.2.3 Optum
2.2.4 3M
2.2.5 3M
2.2.6 3M Merging Quality With Reimbursement
2.2.7 nThrive / Precyse
2.2.8 Dolbey
2.2.9 McKesson
2.2.10 Cerner
2.2.11 TruCode
2.3 Natural Language Computer Assisted Coding of Medical Procedures Forecasts
2.3.1 CAC Market Software and Services Segmentation
2.3.2 CAC Hospitals and Facilities and Physicians Market Segment
2.3.3 Computer Assisted Coding Physician Market
2.3.4 Growth of the U.S. Healthcare Industry
2.4 Making the Shift To ICD-10 Requirements
2.5 Computer Assisted Coding Prices
2.6 Computer Assisted Coding Regional Analysis

3. Computer Assisted Coding Product Description
3.1 3M
3.1.1 3M 360 Encompass System
3.1.2 3M 3M CodeAssist System
3.1.3 3M APR DRG Solutions Aspects
3.1.4 3M Merging Quality With Reimbursement
3.1.5 3M™ APR DRG Software
3.1.6 3 M Classification System For Patients
3.1.7 3M APR DRG Software Features:
3.1.8 3M Coding Technology
3.1.9 3M Computer-Assisted Coding Solutions
3.1.10 3M Medical Coding Tools Streamline Processes
3.1.11 CodeAssist Automating the Medical Coding Process
3.1.12 3M CodeComplete Outsource Solution for Medical Coding
3.1.13 3M DataScout Clinical Data Extraction and Identification
3.1.14 3M and American Academy of Professional Coders (AAPC)
3.1.15 3M Data Mining Technology
3.1.16 3M Systems for Overcoming Documentation Shortfalls
3.1.17 3M Solutions for a Changing Healthcare Landscape
3.1.18 3M Web-Based Coding Software Return on Investment
3.1.19 3M Coding Software Functions
3.1.20 3M Computer-Assisted Coding Solutions Targeted to Specialty Areas
3.1.21 3M CodeAssist Functions
3.1.22 3M CodeComplete Business Process Management
3.2 Dolbey
3.2.1 Dolbey Coding Productivity Management
3.2.2 Dolby Fusion Suite Modules
3.3 Optum Coding Service
3.3.1 Optum Coding
3.3.2 Optum CPT® Codes
3.3.3 Optum Medicare Fee Schedule
3.4 McKesson
3.4.1 Mckesson Watching the Cash
3.4.2 McKesson Securing the Subsidy
3.4.3 McKesson Quality Control And Process Improvement
3.5 Cerner Computer Assisted Coding
3.6 Platocode® Computer-Assisted Coding
3.6.1 Platocode ICD 10
3.6.2 Platocode® Solution For Ambulatory Surgery
3.6.3 Platocode® API
3.6.4 Communication Between 3rd-Party Applications And A Platocode Server
3.7 Nuance Computer Assisted Coding

4. Computer Assisted Coding Research and Technology
4.1 Computer-Assisted Coding Technology
4.2 Hybrid Technology
4.2.1 Computer Assisted Coding Engine
4.3 Optum Computer Assisted Coding Technology
4.4 Natural Language Processing (NLP) Medical Coding
4.4.1 Rules Based Approaches
4.4.2 Reports Based On Statistics
4.4.3 Normalize the Data
4.5 Reports Must Be In Some Kind Of Electronic Format
4.5.1 NLP Software Statistical Analysis
4.5.2 Workflow
4.5.3 Feedback for Machine Learning
4.5.4 Coding
4.5.5 Accuracy And Specificity Of Retrieval
4.5.6 Natural Language Programming (NLP) Vocabulary Processor
4.5.7 Robust Underlying Terminological Model And A Component Architecture
4.6 TeSSI® (Terminology Supported Semantic Indexing)
4.6.1 L&C’s LinkBase® Medical Ontology
4.6.2 Semantic Indexing With The TeSSI® Indexing Engine
4.6.3 Semantic Indexing Solution Automates The Indexing Process
4.6.4 Information Extraction with TeSSI® Extraction Engine
4.6.5 Semantic Search with TeSSI® Search Engine

5. Computer Assisted Coding Company Profiles
5.1 CAC Key Market Players
5.2 3M
5.2.1 3M Business
5.2.2 3M Health Care Segment
5.2.3 3M Electronics and Energy Business
5.2.4 3M Health Information Systems
5.3 Cerner
5.3.1 Cerner Business
5.3.2 Cerner Acquired Siemens Health Services
5.3.3 Cerner 2016 Fourth Quarter and Full-Year Highlights:
5.4 Dolbey
5.5 EPIC
5.6 Group One / CodeCorrect
5.7 M*Modal
5.8 nThrive
5.8.1 nThrive / Precyse
5.9 Nuance
5.9.1 Nuance Healthcare
5.9.2 Nuance Business Description
5.9.3 Nuance Key Metrics
5.9.4 Nuance Healthcare Trends
5.10 Quest Diagnostics
5.11 TruCode
5.12 UnitedHealth Group / Optum
5.12.1 UnitedHealth Group / Optum
5.12.2 UnitedHealth Group Optum Health Information Technology Acquires Clinical Data Analytics Vendor Humedica
5.12.3 Optum Acquires Physician Practice Management And Revenue Management Software Firm, MedSynergies and Support Arm of ProHealth Physicians Group
5.12.4 Optum MedSynergies Synergies
5.12.5 Optum Life Sciences
5.12.6 United Healthcare Revenue
5.13 Selected CAC Companies

List of Figures:
Figure 1. Computer Assisted Coding of Medical Information Market Driving Forces
Figure 2. Computer Assisted Coding of Medical Information Market Driving Factors
Figure 3. CAC Workstation Coder Benefits
Figure 4. CAC Management Tools
Figure 5. Electronic Coding Solution Market Driving Forces
Figure 6. Electronic Coding Product Issues
Figure 7. Computer Assisted Coding Software and Services Market Shares, Dollars, 2016
Figure 8. Computer Assisted Coding Market Forecast, Dollars, Worldwide, 2017-2024
Figure 9. Advantages of CAC In Large Physician Office
Figure 10. Barriers to CAC In Large Physician Office
Figure 11. Electronic Coding Integrated Database Issues
Figure 12. Medical Necessity Online
Figure 13. Physician Office Computer Assisted Coding Key Benefits:
Figure 14. Natural Language Solutions System For Coding
Figure 15. Computerized Workflow System Systems Features
Figure 16. 3M Confidence Assessment Module System
Figure 17. Physician Practices and Ambulatory Care Centers CAC Market Driving Forces:
Figure 18. Large Physician Office Computer Assisted Coding of Medical Information Market Driving Forces
Figure 19. Large Physician Office Computer Assisted Coding of Medical Information Market Driving Factors
Figure 20. Large Physician Office CAC Workstation Coder Benefits
Figure 21. Large Physician Office CAC Management Tools
Figure 22. Large Physician Office Electronic Coding Solution Market Driving Forces
Figure 23. Large Physician Office Electronic Coding Product Issues
Figure 24. Large Physician Practice Computer Assisted Coding Software and Services Market Shares, Dollars, 2016
Figure 25. Worldwide Large Physician Office Computer Assisted Coding License Shipments and Cloud Services, Market Shares, Dollars, 2016
Figure 26. Worldwide Physicians, Hospitals and Facilities, Market Shares, Units and Dollars, 2016
Figure 27. Radiology and Ambulatory Clinic Computer Assisted Coding Software and Services Market Shares, Dollars, 2016
Figure 28. Computer Assisted Coding Software and Services Market Shares, Dollars, 2016
Figure 29. Worldwide Computer Assisted Coding License Shipments and Cloud Services Market Shares, Dollars, 2016
Figure 30. Optum CAC Key Benefits:
Figure 31. Optum LifeCode®, CAC Functions
Figure 32. Optum LifeCode®, CAC Reconciliation Functions
Figure 33. Optum CAC Reconciliation Module Functions:
Figure 34. 3M CAC Research Areas
Figure 35. 3M Core of NLP Computer Assisted Coding
Figure 36. Platocode® Computer Assisted Coding Solution Benefits
Figure 37. Large Physician Office Computer Assisted Coding Market Forecast, Dollars, Worldwide, 2017-2024
Figure 38. Computer Assisted Coding CAC Market Forecasts, Dollars, 2017 to 2023
Figure 39. Large Physician Practice CAC Market Segments Software and Services Key Topics
Figure 40. Worldwide Computer Assisted Coding Hospitals and Facilities and Physicians Market Shares, Dollars, 2016

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  • 3M
  • Artificial Medical Intelligence
  • Cerner
  • Craneware
  • Dolbey
  • EPIC
  • Group One / CodeCorrect
  • M*Modal
  • nThrive / Precyse
  • Nuance
  • Optum
  • Quest Diagnostics
  • TruCode
  • UnitedHealth Group / Optum
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