6 Ways TruBridge Encoder Beats the Competition

Medical coders face a slew of challenges that can have far-reaching consequences for any healthcare organization. The consequences of improper billing reach far beyond revenue loss and include potential fraud or abuse charges and — more importantly — the inability to provide patients with quality care, predict clinical outcomes, and anticipate future patient needs.

A recent review of published studies found that the most common reasons for inaccurate medical billing and coding include a high rate of physician coding errors due to inadequate training; insufficient clinical documentation supporting the level of billing; and a lack of a feedback system aimed at correcting billing errors.  Advances in technology have dramatically improved the speed and accuracy of medical coding in general, but most encoding software solutions leave a lot to be desired.

Not so with TruBridge. Our medical encoder software was meticulously developed with the most important pain points in mind, and it checks all of the boxes. Here are just six ways the Trubridge Encoder beats out the competition.

While many of our competitors rely solely on automation or rigid processes, TruBridge’s medical encoder software uses a knowledge-based methodology that incorporates real-time guidance and prompts to improve speed and accuracy.

Coders often face the dilemma of choosing among several possible codes for a diagnosis or procedure — coding a condition like pneumonia might seem straightforward on the surface, but coders must review detailed clinical documentation to determine the specific type. Similarly, a fracture needs to be coded according to its type, location, and whether it’s open or closed.

And that’s where TruBridge’s knowledge-based system becomes invaluable for helping coders fill in the gaps — especially when it comes to complex, multi-code scenarios.

The contextual resources built into our software include robust references, guidelines, and real-time prompts based on all available documentation. Detailed explanations for the reasoning behind code suggestions help coders apply their professional judgment with greater confidence, and automatic checks help reduce errors that might otherwise slip through undetected. The system also suggests codes for complications or related conditions, streamlining the entire process for complex cases.

In cases where documentation is incomplete or unclear, the chances of inaccurate coding skyrocket — and coders know all too well the delays and frustration that often come with following up with physicians for clarification. To that end, the TruBridge Encoder even suggests follow-up questions, reducing the need for manual back-and-forth between coders and providers.

The sheer volume of codes required for many medical cases is enough to scramble the brains of even the most seasoned coder. Add to that the variations in payer-specific coding requirements and the long list of regulatory guidelines, and it’s easy to see why coding errors account for an annual loss of up to $20 billion in laboratory claims alone.

While many of the medical coding software solutions on the market today still require coders to spend a lot of time toggling back and forth among multiple references to find the information they need, the TruBridge Encoder consolidates scores of coding references directly into the software, including:

But we didn’t stop there — our software also has built-in features that account for the specific requirements of different payers, including payer-specific rules for coding, claim submission formats, and reimbursement guidelines. Built-in coding compliance features help ensure adherence to HIPAA, OIG, and other regulatory standards, and audit trails and reports make quick work of coding cleanup projects and demonstrating compliance during audits.

The healthcare industry is accustomed to frequent updates to codes and regulations, but even so, keeping up with it all is one of the most challenging aspects of medical coding. Many of our competitors still peddle on-premise solutions where updates can take an inordinate amount of time, which can be a real nightmare for very large healthcare systems and smaller hospitals and clinics with limited IT resources.

The TruBridge Encoder is a cloud-based solution, which means it receives real-time updates to clinical content, coding regulations, and references without requiring manual software installations or patches. Coders always have the latest information available at their fingertips.

Without adequate user support, even the most robust encoder solutions will fall short in solving the issues they’re designed to address. TruBridge has earned a reputation for its exceptional customer service — unlike some of our competitors, where getting support requires navigating a maze of automated messages and long wait times, TruBridge products come with around-the-clock support from real people who understand medical coding and RCM.

We also address the challenges healthcare organizations face in keeping their coding staff up to date with the latest coding practices and industry changes. TruBridge offers educational webinars and continuing education units (CEUs) to help keep coding teams current, build their skills, and boost their confidence.

When it comes to managing the revenue cycle, a “one-size” solution can’t possibly “fit all.” The same solution that works perfectly for a large hospital will inevitably be too bulky for a small clinic to efficiently integrate into its workflow.

The TruBridge Encoder stands apart from the competition for its flexible, customizable — and therefore cost-effective — solutions. A modular design means healthcare providers only pay for what they need, and easy end-to-end integration with other revenue cycle management systems, from billing and invoicing to managing claims and denials, streamlines the overall workflow to improve clean claim rates and reduce revenue leakage.

The TruBridge Encoder provides your coders with easy, built-in access to all of the tools and resources they need for maximum efficiency and accuracy. While many encoding software solutions either prioritize accuracy or speed, TruBridge balances both — and serves up a heaping helping of product support and continuing education to boot.

If you’re ready to enjoy the peace of mind that comes with knowing you’ve chosen the best possible solution for your organization’s unique needs and coding challenges, we’d love to show you how it works.

Request a TruBridge Encoder demo today, or come see us October 27–29 at the AHIMA24 Conference in Salt Lake City — we’ll be at Booth 618.