The Medical Coding Whisperer

By Dr. Nick van Terheyden aka Dr. Nick
Twitter: @drnic1
Host of Dr. Nick: The Incrementalist#TheIncrementalist

On this episode I talked to Abboud Chaballout, founder/CEO of Diagnoss, the medical coding “whisperer” company. Like many of my guests Abboud has an interesting journey, in his case through law school developing experience founding and building companies as an entrepreneur and working in the medical coding and billing world where he learnt about money flow in the healthcare system and especially in medical offices. Along the way he discovered the challenge of many medical offices and systems trying to manage their debt and revenue cycle which all served as a foundation to creating Diagnoss a company using AI insights to offer real time help to doctors.

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As he points out there are two coding points in most parts of the healthcare system where a code is selected and the translation mechanism is driven primarily by reimbursement. Get a code, get reimbursed, but this fails the system and the everyone working in the system.

The selection of a code takes place with a coder and a physician in partnership. The physician picks codes, an activity they were not trained for and have no time to find those codes from a huge list that is poorly filtered and then passed on to a medical coder who is trained to pick codes but did not train in medical school and does not have the full context the clinicians to.

This reminds me a lot of the early days of medical transcription where transcriptionists were in a related role and as they learnt and added to their clinical knowledge the really experienced medical transcriptionists would be able to give the diagnoses on a medical transcription before it was diced by listening to the details of the dictation/note.

With the Diganoss system the physician receives real time insights to help the doctor pick codes as they progress through documenting the case in the EHR. The system uses metadata from multiple sources to guide a more customized list of options based on the individual physician supplemented by the context of patient and the clinical information. The system also uses the clinical documentation from the EHR to provide more filtering of choices offered and will remind the physician to include codes from all the available clinical information.

Listen in to hear how they achieve insights that can be delivered to the physician at the point of care to provide better, faster more accurate billing and the exciting future that starts to offer additional suggestions such as tests that the physician would like want to order helping solve one of the ongoing challenges of administrative burdens that adds to clinic burnout.

About the Show
For years Dr. Nick van Terheyden aka Dr. Nick, has served as a voice on the impact of new technologies on healthcare, earning a reputation as a leading authority on where the future of medicine is going. Combining powers of observation and real world experience, Dr. Nick has seen many predictions come true and makes the case that innovations in healthcare can be accomplished incrementally, not just by moonshot events. Tune in to hear Dr. Nick: The Incrementalist and his guests discuss what the future of healthcare looks like, how we will get there, and what it will take to improve healthcare for all.

This article was originally published on the Dr. Nick – The Incrementalist blog and is republished here with permission.