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Boosting Billing Efficiency with the Clinical Rule Engine

28 March 2024
Blog

eClinicalWorks

stethoscope and pen on top of medical billing paperwork and charts

Artificial Intelligence (AI) for Robotic Process Automation (RPA) through Automated Playlists uses multi-screen navigation to reduce time spent on repetitive manual tasks, which enhances efficiency.

This functionality is key to the effectiveness of the Clinical Rules Engine (CRE). It’s a powerful tool that has revolutionized the way providers handle billing and coding. It automates the process of applying billing codes based on documentation, streamlining operations and minimizing the possibility of human error.

CRE in Action

Michigan-based McKenzie Health System uses CRE and RPA via eClinicalWorks® (eCW) V12 to improve operations and ensure consistent patient care and better staff workflows.

With 9K patients across six primary care clinics, three specialty clinics, and an after-hours clinic, McKenzie felt the crush of administrative burdens due to repetitive coding for patient visits. They were further stretched due to location, as McKenzie clinics are in rural areas. This means that patients may need to travel significant distances to receive care.

Using the CRE, McKenzie can automate codes with data captured from a care visit. CRE reminders and alerts help providers and staff submit the correct coding and billing information on the first try to minimize duplicated efforts.

As far as the rural locales are concerned, CRE has that covered. CRE provides prompts and alerts for providers to initiate communication for follow-up care in a timely manner for patients who may need to travel a long way to meet with their doctor. This ensures that patient needs are met and office visits are streamlined to make the most of their time.

CRE also eases the burden on staff thanks to RPA. During a typical patient visit, there are several codes that staff need to input. There are a lot of codes to remember. And if codes are missed or input incorrectly, it has a negative impact on the billing process.

With the CRE via RPA, everything is improved. It automatically drops the appropriate codes based on the clinical documentation for more accuracy. Staff members don’t have to remember hundreds of codes because CRE knows them and where they go. This frees the staff to spend less time on coding and more time on patient care.

“With the eClinicalWorks Clinical Rules Engine, we see a significant improvement in our coding process,” said Angela Stratton, clinical IT quality specialist at McKenzie Health System. “The Clinical Rules Engine automatically drops the appropriate codes based on documentation. Our staff spends less time coding and can focus their attention on direct patient care. This is an amazing tool within eClinicalWorks, and I recommend it to all eClinicalWorks users.”

Thanks to AI for RPA through Automated Playlists, CRE is a game-changing technology and practice-improving functionality. Discover how it, as well as other AI-powered aspects of the eCW EHR, can power the performance of your practice at www.eclinicalworks.com.