Ten Questions for CAC Vendors

An increasing number of healthcare facilities are turning to computer-assisted coding (CAC) to streamline workflows and help reduce coding workloads. Others are giving the technology a close look for the first time.

“Interest in the technology has grown significantly over the past few years,” says June Bronnert, RHIA, CCS, CCS-P, director of professional practice resources at AHIMA and co-author of the AHIMA “CAC 2010–11 Industry and Resources Report.”

“People are becoming more comfortable with the technology, and it keeps improving as time goes on,” Bronnert continues. “I also think that [facilities are under] a lot of pressure to improve and streamline processes.”

With the interest come questions. HIM managers and staff alike want to know how CAC works and how it would integrate with and alter their existing workflows.

Questions are natural with any new technology. But sometimes knowing just what questions to ask can be difficult.

That’s why Bronnert and report coauthors created a list of 10 questions that coding supervisors and HIM directors can use to zero in on what to ask when discussing products with CAC vendors. Managers also can use the list as a questionnaire in comparing products.

One question all HIM and coding managers should ask is what methodology the CAC system uses to determine suggested codes.

“Knowing and understanding the foundation of how the technology works is going to help you know what it is you are getting and how it is going to help your process,” Bronnert says. “It will raise your comfort level and your confidence in the [system] to know that it is giving you the right code.”

Prospective buyers should also understand how vendors keep their products current, including coding updates and routine maintenance.

“If you don’t have the most accurate codes you obviously are not producing complaint codes, because you are behind. And if the system has to be down for maintenance for any extended period of time, it affects your productivity and has other impacts,” Bronnert says.

Getting a full understanding of how a CAC technology would integrate into the facility’s current HIM functions is also important. Before asking the question, HIM and coding managers should complete a workflow evaluation to identify problem areas they want CAC to address, such as coder shortages, slow coding rates, et cetera. Documenting workflow and prioritizing problem areas allows a manager to map a prospective CAC product to the facility’s needs and will identify the needed interfaces with the facility’s multiple clinical systems.

If you understand the technology and what it is capable of doing, then you can identify the trouble spots in your workflow that it could help improve, Bronnert says.

“There would be nothing worse than trying to solve a problem that is really out of the scope of the technology,” she says.

Top Ten Questions to Ask CAC Vendors
  1. How does the CAC system determine the suggested code?
  2. What is the process for supporting clients’ coding issues and responding to questions or concerns?
  3. Which code sets are in the system? Is ICD-10-CM/PCS in addition to ICD-9-CM and HCPCS/CPT in the tool?
  4. How does the CAC system integrate into current HIM functions? For example, what types of documents are accepted by the tool?
  5. What are the interface and other technical requirements of the CAC system in order to gain maximum benefit?
  6. Please explain the coding management capabilities of the system, such as what reports are generated by the system and to what extent the coding workflow can be customized?
  7. Does your company have documentation describing the return on investment of the CAC system in addition to references?
  8. How is ongoing maintenance of the CAC system handled?
  9. What implementation services are provided by your company?
  10. Does the system ever send codes directly into a billing system without coder review? If so, how do you ensure the system is making the right decisions and what evidence does it use to make those decisions?

The “CAC 2010–11 Industry and Resources Report” was sponsored by 3M, Nuance, Artificial Medical Intelligence, QuadraMed, and Ingenix.

2 Comments

  1. Thanks so much for this valuable information. We are beginning to work on the EMR, which should be complete on 03.01.12. We now use the TruCode Encoder, which I love. Our vendor (Cerner) will be using Ingenix, which I have never used, other than in books! I don’t quite understand totally how CAC works, I have a lot of questions. We are also wondering if this will create downsizing for coders in the future, and are concerned about job security.
    We will be outsourcing all our ER coding (in the near future) to a private company who is responsible for hiring our ER hospitalists.

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  2. I don’t see any articles that talk about validating the computer assisted codes or how to system test for Computer Assisted Coding before implementation.

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