1. / An EMS Firm Recovers More than 50% Savings in FTE
Overview

In the world of emergency medical services (EMS), every now and then, a new legislative law is imposed, or amendments or repeals are made on existing ones. They face frequent changes to the reimbursement formula, the addition of new billable services, and even bans on certain payments. Only a flexible, agile, and automated digital system can cater to these rapid needs and assure compliance. The customer, an EMS firm that serves more than 2 million ambulance trips a year, wanted to deploy a low-cost SaaS solution that automates EMS coding, manages fluctuating volumes, and adheres to regulations.

Problem

While processing 5,000 ambulance trips on a daily basis, the client found it difficult to:

  • File the high volumes of claims in time and with the required accuracy
  • Establish consistency in coding to eliminate revenue leakage
Solution

Apexon implemented the ApexEMS coding solution to simplify the medical coding process through machine learning algorithms and Driverless AI, that: 

  • Determines the appropriate service codes while billing. 
  • Imparts greater accuracy by automating the entire lifecycle of EMS coding
  • Uses advanced NLP techniques to codify claims and applies recurrent neural network models enabling context-sensitive predictions
  • Creates a secure, encrypted, and web-enabled environment that meets HIPAA compliance protocols
Impact

Through ApexEMS, the customer was able to realized the benefits of:

  • More than 50% savings in FTE and related costs
  • 8-10% reduction in financial leakage through improvements in clinical documentation 
  • 40-50% reduction in audit efforts
  • 3-5% improvements in quality score

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