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

The Coder Workbench improves efficiency, accuracy, and coder productivity

Wolters Kluwer Health 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.

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“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.”

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

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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.

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