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FATHOM

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CODAMETRIX AUTONOMOUS MEDICAL CODING PLATFORM

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CODAMETRIX AUTONOMOUS MEDICAL CODING PLATFORM

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CODAMETRIX AUTONOMOUS MEDICAL CODING PLATFORM

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Categories


Revenue Cycle Management (RCM), Coding & Documentation
Revenue Cycle Management (RCM), Coding & Documentation

Solutions



Medical Coding

Medical Coding

Clinical Documentation Integrity (CDI)

Documentation, Billing, and Coding Support

Description



PRODUCT DESCRIPTION:

Fathom is an autonomous medical coding platform that provides accurate,
complete, touchless coding for ICD, CPT/HCPCS, E/M, modifiers, provider
assignment, units, shared services, deficiencies, and all other required coding
elements across specialties. With Fathom, providers benefit from:

 * 90%+ successful automation rates: Of all patient encounters provided to
   Fathom for coding, around 90% or more are successfully coded autonomously or
   correctly flagged for documentation deficiencies.
 * 96%+ accuracy rates: Ongoing audit programs ensure greater-than-human coding
   accuracy.
 * 30-50% cost savings: Fathom delivers an average 42.3% reduced cost to code.
 * Denials reduction: Stronger accuracy and immediate flagging of documentation
   deficiencies fix coding errors upstream and reduce denials.
 * RVU increase: Through higher coding accuracy, especially on E/Ms, Fathom
   typically results in a meaningful improvement to revenue capture.
 * Lightning-fast turnarounds: Fathom typically returns complete coding results
   for the day's encounters within 2 hours, averaging 57 min.
 * Industry-leading SLAs: Contractual commitments to guarantee performance for
   automation, accuracy, turnaround time, and other metrics.

Through a risk-free trial, Fathom enables providers to validate our coding
quality for themselves before turning on production-ready models upon go-live.
In production, Fathom receives clinical documentation from EMRs following
patient visits, fully codes the encounters according to guidelines and payer
rules, and returns complete coding results for claim submission. This consistent
application of coding guidelines improves outcomes and enables enterprise-wide
compliance.

ABOUT FATHOM:

Fathom is an autonomous medical coding platform that uses deep learning and LLMs
to provide accurate, complete coding for E/M, CPT/HCPCS, ICD, provider
assignment, deficiencies, and other coding elements across specialties.

PRODUCT DESCRIPTION:

CodaMetrix is a SaaS platform, hosted in the AWS Cloud environment, that uses AI
and ML to interpret clinical data from the Electronic Health Record (EHR) to
reduce time and cost of coding while increasing the quality of coding data sets.
It works in parallel with existing coding processes, automatically billing codes
and providing medical coding teams with context and suggestions for
low-confidence codes. 



CodaMetrix currently supports Epic, GE, Meditech, and Cerner and can be expanded
to other EHRs. It is available in Radiology, Pathology, Endoscopy, Surgery, and
Evaluation & Management service lines with planned expansion into Emergency
Department (ED) and other specialties. CMX Insights includes a dashboard with
analytics on automation rate and accuracy, as well as Coding Decision Support
tools.

ABOUT CODAMETRIX, INC.:

CodaMetrix is an AI-powered SaaS platform dedicated to transforming medical
coding, serving health systems that use Epic in more than 220 hospitals,
performing over 50 million patient visits with 60,000 physicians across 25
states. The CodaMetrix platform leverages the latest in AI technology to deliver
automation in a growing number of specialty and sub-specialty areas. Providers
using CodaMetrix experience a 60% reduction in coding costs, a 70% reduction in
claims denials, a 5-week acceleration in time to cash, and an average successful
automation rate above 96%.

Compatibility level



SELECT WHICH HOSPITAL OR HEALTH SYSTEM YOU WORK AT AND SEE A PERSONALIZED
COMPATIBILITY LEVEL.

Get Started



Clients



SELECT WHICH HOSPITAL OR HEALTH SYSTEM YOU WORK AT AND SEE THE CLIENT LIST

Get Started



Product Capabilities




Intelligent Automation




CodaMetrix leverages AI technologies in our platform to learn relationships
between clinical documentation and billing codes, as well as to adapt to each
customer's unique documentation styles and coding standards. We develop and
maintain our own proprietary AI algorithms in-house, including machine learning,
deep learning, and natural language processing capabilities. We do not rely on
or partner with any third-party AI/machine learning vendors.

Advanced Analytics and Reporting




The CMX Insights™ Platform displays information about charge related data
received from the Customer’s EHR system, including cases which have been
automated and those that have been passed along to the Customer’s existing
manual solution or processed manually. The analytics can be accessed to
understand why a charge was automatically coded and provides evidence of all
coding decisions and predictions. Finally, CMX Insights™ are used to analyze
volumes processed by date range, and case-specific information. Dashboards
include but are not limited to: - Real-time performance - Financial impact
analytics - Productivity monitoring - Denial management tracking

Compliance and Security




CodaMetrix has implemented both the technical and procedural safeguards to
operate with HIPAA compliance at the forefront. CMX has achieved ISO 27001
certifications and SOC 2 Type 2 compliance in addition to implementing the
necessary controls (encryption in motion and at rest, full audit trail, ISMS,
3rd party penetration testing, static and dynamic code vulnerability scanning,
role-based security, least privileged security model, etc).

Denial Management and Prevention




CodaMetrix is committed to reducing denials through our autonomous coding
solution. We have proven to reduce denials by more than 50-60% compared to
manual coding. For example, a study of radiology claims at Mass General Brigham
showed that denials-for-coding dropped by more than 58.7% after implementing
CodaMetrix. We also analyze denials information shared by customers to improve
our artificial intelligence and autonomous coding capabilities.

Use Cases



DESCRIPTION:

Fathom is an autonomous medical coding platform that provides accurate,
complete, touchless coding for ICD, CPT/HCPCS, E/M, modifiers, provider
assignment, units, shared services, deficiencies, and all other required coding
elements across specialties. With Fathom, providers benefit from:

 * 90%+ successful automation rates: Of all patient encounters provided to
   Fathom for coding, around 90% or more are successfully coded autonomously or
   correctly flagged for documentation deficiencies.
 * 96%+ accuracy rates: Ongoing audit programs ensure greater-than-human coding
   accuracy.
 * 30-50% cost savings: Fathom delivers an average 42.3% reduced cost to code.
 * Denials reduction: Stronger accuracy and immediate flagging of documentation
   deficiencies fix coding errors upstream and reduce denials.
 * RVU increase: Through higher coding accuracy, especially on E/Ms, Fathom
   typically results in a meaningful improvement to revenue capture.
 * Lightning-fast turnarounds: Fathom typically returns complete coding results
   for the day's encounters within 2 hours, averaging 57 min.
 * Industry-leading SLAs: Contractual commitments to guarantee performance for
   automation, accuracy, turnaround time, and other metrics.

Through a risk-free trial, Fathom enables providers to validate our coding
quality for themselves before turning on production-ready models upon go-live.
In production, Fathom receives clinical documentation from EMRs following
patient visits, fully codes the encounters according to guidelines and payer
rules, and returns complete coding results for claim submission. This consistent
application of coding guidelines improves outcomes and enables enterprise-wide
compliance.

PEDIATRIC USE CASES:

None provided

USERS:

Health systems, hospitals, physician groups, ambulatory providers, risk-bearing
providers, health plans, and other organizations.

DESCRIPTION:

CodaMetrix provides autonomous coding services for the following specialties for
both inpatient and outpatient scenarios:

 * Diagnostic Radiology
 * Interventional Radiology
 * Anatomic Pathology
 * GI and Special Procedures
 * Surgery
 * Bedside Professional Visits
 * ED expected in 2025 
 * Ambulatory expected in 2025

PEDIATRIC USE CASES:

Yes, CodaMetrix is currently contracted with Children's Health Systems. 

USERS:

The primary users of the CodaMetrix platform are designated Medical Coders. A
goal of our system is to alleviate doctors of the task of medical coding and
other administrative burdens.

EHR Integrations



INTEGRATIONS:

Acute care EMR, Ambulatory EMR, Ancillary EMR, Pop health platform, Home health

EMR INTEGRATION & RELEVANT HARDWARE:

Use case dependent

EMRS SUPPORTED:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, eClinicalWorks,
Athenahealth, MEDHOST, Self-developed

HARDWARE COMPATIBILITY:

Not applicable

IN EPIC SHOWROOM

https://showroom.epic.com/Listing?id=1184

INTEGRATIONS:

Acute care EMR, Ambulatory EMR, Ancillary EMR, Pop health platform, ADT, Access
+/or revenue cycle

EMR INTEGRATION & RELEVANT HARDWARE:

Use case dependent

EMRS SUPPORTED:

Epic, Cerner, Other, Meditech, athena, Athenahealth, GE

HARDWARE COMPATIBILITY:

Mobile / Tablet (web optimized), Desktop

IN EPIC SHOWROOM

https://showroom.epic.com/Listing?id=1175

Client Types



Pediatric Hospitals

Academic Medical Centers

Accountable Care Organizations

Rural Hospitals

Small Medical Facilities

Large Medical Facilities

Health Insurers

Long-Term Care

Home Healthcare

Diagnostics and Imaging Centers

Medium Medical Facilities

Extra Large Medical Facilities

Pediatric Hospitals

Academic Medical Centers

Accountable Care Organizations

Large Medical Facilities

Diagnostics and Imaging Centers

Extra Large Medical Facilities

Awards





Differentiators



DIFFERENTIATORS VS EHR FUNCTIONALITY:

None provided

DIFFERENTIATORS VS COMPETITORS:

None provided

DIFFERENTIATORS VS EHR FUNCTIONALITY:

 * Codametrix offers fully autonomous coding vs. computer assisted coding
   (suggested code sets) 
 * Professional coder productivity reporting
 * Ease of performing QA and auditing with Coding Manager tools for self service
   coding QA (including building in custom rules and sampling)

DIFFERENTIATORS VS COMPETITORS:

 * Automation Accuracy: CodaMetrix exceeds 96% in this metric, setting a new
   standard for the industry.



 * Coding quality: CodaMetrix is built on clinically validated data to ensure
   superior accuracy and provides the adaptability necessary to serve your
   specific needs.



 * CodaMetrix offers CMX Amplify™—our coding decision support tool that measures
   coder productivity, accuracy, and proficiency, while helping generate
   high-quality data.



 * Performance analytics: The CodaMetrix platform's advanced analytics
   capabilities position users to make data-driven decisions more effectively. 



 * Provider-owned: CodaMetrix is a provider-owned company that is
   organizationally designed to deliver proven solutions to our fellow
   healthcare industry providers.



 * As the Epic Toolbox member that has been live with numerous Epic healthcare
   organizations for years, we bring unmatched experience to the market,
   consistently meeting Epic’s integration requirements.

Health Equity




Privacy




in the interests of ensuring the security and privacy of the customer data,
CodaMetrix has a dedicated site-to-site VPN connection for each CMX customer,
meaning that all communications for that environment are routed through the
dedicated VPN tunnel. Communications through these dedicated VPN tunnels are
encrypted at rest and in transit, ensuring the protection and security of the
data. Additionally, CodaMetrix employs a “least-privileged” security model where
users are given access to the minimum resources required to perform their job.
All PHI is sequestered in PHI-specific accounts and only users who require
access to PHI to perform their job are granted access to these accounts. There
is also extensive logging that is maintained in a separate AWS account for
access and use patterns; CodaMetrix has advanced Google tools monitoring our
environment specifically for data loss and warn on potentially leaked
information. CodaMetrix has extensive policies in place to keep PHI segregated
and keep it from being copied to outside locations.

User support




Designated users at customer sites receive access to the CodaMetrix Support
Portal where they can view knowledge base resources, support case information,
and application uptime/maintenance status. General support calls are triaged
within 24 hours of receipt. Calls over the weekend (received after 5:00 pm PST)
on Fridays will be picked up the next business day. Downtime is handled as a
Severity 1 incident and will receive immediate attention and be worked to
resolution with regular updates. All workflows are monitored during the
non-support hours and triaged as needed. Support tickets may be opened via email
(support@codametrix.com), phone (857-263-3264), or online via our dedicated
Salesforce customer portal. If an outage were to occur, CodaMetrix has detailed
Business Continuity processes and procedures that that include a documented
Disaster Recovery plan to ensure a rapid return to business operations

Keywords


autonomous medical coding,medical coding,AI medical coding,automated medical
coding,HCC medical coding,medical coding ai,medical coding automation,hcc
coding,medical coding software
intelligent automation,advanced analytics,medical coding,autonomous medical
coding,AI medical coding,automated medical coding,coding guidance,coding gap
closure

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FATHOM IS A MEDICAL CODING AI

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CodaMetrix Differentiators 1-Pager - August 2024 (2).pdf

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