iCode Assurance™ by GeBBS is a comprehensive, customizable Software-as-a-Service (SaaS) platform designed to optimize and accelerate the medical code auditing process for healthcare organizations. It supports both concurrent and retrospective coding audits across all points of care, including inpatient, outpatient, professional, performance measures, and HCC (Hierarchical Condition Category) coding.
The platform is built upon industry best practices, adhering to the Office of Inspector General (OIG) audit methodology and AHIMA's best practices standards, ensuring accurate and compliant coding for both facility and professional fee records.
Key Features and Capabilities
- Autonomous Coding Audits: Utilizes AI to conduct a dual-level coding and review process, minimizing human intervention, enhancing productivity, and improving quality while reducing denials.
- Denial Prediction: Foresees potential claim rejections before submission, alleviating the need for rework and enhancing cash flow.
- Customizable Workflow: Offers configurable workflows tailored to meet unique organizational needs and can be utilized by internal teams, GeBBS' team, or a combined team.
- Comprehensive Reporting & Analytics: Provides interactive audit management dashboards, detailed scorecards, and robust reporting for real-time executive-level insights on detailed accuracy, error trending, revenue variance, and RVU impact.
- Compliance Program Management: A comprehensive solution that captures audit findings, generates scoreboards, and provides performance reports to manage compliance.
- Claims Data Aggregation: Collects data from disparate sources, including spreadsheets, charts, providers, and healthcare management systems, into a single repository for auditing.
Target Users and Use Cases
iCode Assurance is an enterprise solution primarily targeting hospitals, large health systems, and providers (e.g., Johns Hopkins Health System, Memorial Sloan Kettering Cancer Center).
Primary Use Cases:
- Medical Coding Audit: Streamlining both concurrent and retrospective audits for facility and professional fees.
- Compliance Risk Mitigation: Identifying and rectifying coding discrepancies to ensure adherence to OIG and AHIMA standards.
- Revenue Cycle Management (RCM) Optimization: Improving overall coding quality, increasing clean claim ratios, and capturing missed revenue opportunities.
- Coder and Provider Education: Providing access to audited and scored records for training, education, and process improvements.