SYSTEMS AND METHODS FOR A MEDICAL CODER MARKETPLACE
Systems and methods for a coder marketplace are provided. The system has procedures for certification of a number of medical coders. The proficiency of the coders is subsequently measured. When the system receives medical records in need of coding, the documents can be routed to one or more coders based upon proficiency of the coders, payment model, availability, or some other criteria. Lastly, the system can facilitate a financial transaction between the coder and the provider who supplied the medical records for coding. Proficiency includes the speed of a coder, as well as accuracy, and can be measured by providing the coder a medical record for which the coding is already established and comparing the coder's output to the known values.
1 . In a health information management system, a method for administering a medical coder marketplace, the method comprising:
certifying a plurality of medical coders for baseline competency;
measuring a proficiency level for each of the plurality of medical coders;
receiving a medical record in need of coding from a provider;
routing the medical record to one of the plurality of medical coders based upon the proficiency level of each of the plurality of medical coders; and
facilitating a financial transaction between the provider and the medical coder to which the medical record has been routed.
2 . The method of claim 1 wherein the proficiency level includes time spent to code a record and accuracy of coding.
3 . The method of claim 2 wherein the proficiency level is calculated granularly for a number of medical fields.
4 . The method of claim 2 wherein measuring the proficiency level comprises:
presenting the medical coder with a known medical record, wherein the known medical record is one for which the coding is already established;
collecting coding data for the known medical record from the medical coder, wherein the coding data includes time spent coding; and
comparing the collected coding data against the established coding to determine accuracy.
5 . The method of claim 1 wherein the routing of the medical record to one of the plurality of medical coders includes optimizing at least one of throughput and accuracy of medical records coded, wherein the optimization compares availability of each of the plurality of the medical coders, proficiency level of each of the plurality of medical coders, and number of medical records requiring coding.
6 . The method of claim 1 further comprising presenting the proficiency level of each of the plurality of medical coders to the provider.
7 . The method of claim 6 wherein the routing of the medical record to one of the plurality of medical coders is performed by selection by the provider for a particular medical coder's time.
8 . The method of claim 7 wherein the selection of the particular medical coder is performed via a bidding process.
9 . The method of claim 7 wherein the selection of the particular medical coder is based upon a given cost structure dependent upon the proficiency level of the particular medical coder.
10 . The method of claim 1 further comprising providing the medical record to more than one medical coder in order to ensure enhanced coding accuracy.
11 . The method of claim 1 wherein the medical record is selected from a plurality of pre-audited medical records.
12 . A medical coder marketplace comprising:
a certification module configured to certify a plurality of medical coders for baseline competency;
a coder analyzer configured to measure a proficiency level for each of the plurality of medical coders;
an interface configured to receive a medical record in need of coding from a provider;
a record router configured to route the medical record to one of the plurality of medical coders based upon the proficiency level of each of the plurality of medical coders; and
a financial engine configured to facilitate a financial transaction between the provider and the medical coder to which the medical record has been routed.
13 . The system of claim 12 wherein the proficiency level includes time spent to code a record and accuracy of coding.
14 . The system of claim 13 wherein the coder analyzer is further configured to calculate the proficiency level granularly for a number of medical fields.
15 . The system of claim 14 wherein measuring the coder analyzer measures the proficiency level by:
presenting the medical coder with a known medical record, wherein the known medical record is one for which the coding is already established;
collecting coding data for the known medical record from the medical coder, wherein the coding data includes time spent coding; and
comparing the collected coding data against the established coding to determine accuracy.
16 . The system of claim 12 wherein the record router is configured to optimize at least one of throughput and accuracy of medical records coded, wherein the optimization compares availability of each of the plurality of the medical coders, proficiency level of each of the plurality of medical coders, and number of medical records requiring coding.
17 . The system of claim 12 wherein the interface is further configured to present the proficiency level of each of the plurality of medical coders to the provider.
18 . The system of claim 17 wherein the routing of the medical record to one of the plurality of medical coders by the record router is performed by selection by the provider for a particular medical coder's time.
19 . The system of claim 18 wherein the selection of the particular medical coder is performed via a bidding process.
20 . The system of claim 18 wherein the selection of the particular medical coder is based upon a given cost structure dependent upon the proficiency level of the particular medical coder.
21 . The system of claim 12 wherein the record router is further configured to provide the medical record to more than one medical coder in order to ensure enhanced coding accuracy.
22 . The system of claim 12 wherein the medical record is selected from a plurality of pre-audited medical records.