New Wolters Kluwer Health Language Solution Is Purpose-Built to Transform the Risk Adjustment Market

Rhea-AI Summary

Wolters Kluwer Health has launched the Coder Workbench, a new high-productivity solution designed to enhance coder efficiency by 20-40% through optimized medical record reviews for risk adjustment workflows. This tool features intuitive workflows, embedded Medicare Advantage intelligence, and intelligent chart organization. Key attributes include a smart chart organization interface, built-in coding assistance, and AI-driven natural language processing to extract clinical indicators. With Medicare Advantage enrollment exceeding 30 million, the tool aims to address compliance and coding accuracy amidst increasing regulatory scrutiny.

Positive

• Coder Workbench enhances coder efficiency by 20-40%.
• Integrates advanced AI and NLP for better risk adjustment performance.
• Offers tailored coding support with embedded guidelines for improved accuracy.

Negative

• Increased regulatory scrutiny on Medicare Advantage may impact future operations.

The Coder Workbench improves efficiency, accuracy, and coder productivity

WALTHAM, Mass.--(BUSINESS WIRE)-- Wolters Kluwer Health today announced the launch of the Coder Workbench, a high-productivity Risk Adjustment solution built on the Health Language Data Platform that optimizes medical record review for risk adjustment workflows. The tool improves coder efficiency 20-40%*, with embedded Medicare Advantage business intelligence, intuitive workflows, and intelligent chart organization features. The Coder Workbench application in the Health Language Risk Adjustment Suite brings together semantically enriched medical terminology with clinically intelligent natural language processing (NLP) technology to automate the identification of valuable patient health insights in medical records.

Key features of Coder Workbench include:

• Smart chart organization: The user interface creates a table of contents within the medical chart for coders to navigate sections efficiently.
• Built-in coding assistant: Auto-populate and code refinement tools ensure complete and accurate ICD-10 and HCC code capture for maximum coder review speed and accuracy.
• Embedded coding guidelines: Code-specific logic and guidelines are integrated to ensure sufficient evidence for code capture and can be customized for payer-specific policies
• AI-assisted, clinically intelligent NLP: Algorithms trained to understand and extract clinical indicators captured in unstructured text within the medical record (up to 80% of clinical documentation).
• Proprietary clinical terminologies: Semantically enriched terminology libraries ensure superior ICD-10 code refinement.
• Management dashboard: View coder productivity and chart review projects across vendors and internal team for better visibility into quality and performance

Reimagining risk adjustment with clinically tuned technology

According to new data from the Centers for Medicare & Medicaid Services (CMS), enrollment in Medicare Advantage has topped 30 million, drawing increased regulatory scrutiny with a special focus on risk adjustment data validation (RADV). Following the final rule from CMS on RADV audits, published on January 30, 2023, Medicare Advantage insurers should consider solutions that can improve coding accuracy and mitigate their risk of noncompliance and related fines.

“The Coder Workbench is purpose-built to transform the current risk adjustment process, which is generally time-consuming and error-prone even with the application of existing technology which continues to fall short," said Anne Donovan, Vice President and General Manager, Health Language, Wolters Kluwer Health. “The combination of our clinical experience and proprietary terminology engine enables us to deliver a superior solution trained in medical nuance, making it uniquely capable of meeting both current and future needs of our health plan customers.”

Wolters Kluwer Health provides trusted clinical technology and evidence-based solutions that engage clinicians, payers, patients, analysts, researchers and students in effective decision-making and outcomes across healthcare. The division of Wolters Kluwer supports clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions.

*Based on internal testing

About Wolters Kluwer

Wolters Kluwer (EURONEXT: WKL) is a global leader in professional information, software solutions, and services for the healthcare; tax and accounting; governance, risk and compliance; and legal and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with technology and services.

Wolters Kluwer reported 2022 annual revenues of €5.5 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

For more information, visit www.wolterskluwer.com, follow us on LinkedIn, Twitter, Facebook, and YouTube.

For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth

View source version on businesswire.com: https://www.businesswire.com/news/home/20230301005244/en/

Media

André Rebelo

Public Affairs & Public Relations Director

Wolters Kluwer

+1 (781) 392-2411

andre.rebelo@wolterskluwer.com

Source: Wolters Kluwer Health

FAQ

What is the Coder Workbench launched by WTKWY?

The Coder Workbench is a high-productivity solution for improving coder efficiency in medical record reviews, enhancing risk adjustment workflows.

How much does Coder Workbench improve coder efficiency?

The Coder Workbench improves coder efficiency by 20-40%.

What technologies are used in Coder Workbench?

Coder Workbench utilizes AI-driven natural language processing and embedded business intelligence for risk adjustment.

What are the implications of Medicare Advantage enrollment surpassing 30 million for WTKWY?

The increase in Medicare Advantage enrollment can lead to heightened regulatory scrutiny, impacting compliance and coding practices.

When was the Coder Workbench announced?

The Coder Workbench was announced by Wolters Kluwer Health on March 1, 2023.