The Vendor is required to provide autonomous coding solution.
- Software and services shall:
• Use artificial intelligence (AI) and machine learning (ML) to make accurate code assignments while reducing revenue leakage and denials to promote a clean claims process.
• Provide accurate and compliant autonomous coding consistently with a high level of confidence by reading structured and unstructured medical documentation and have ability to extract data such as diagnoses procedures, lab data, patient demographics, SDOH, etc.
• Provide technology that uses clinical intelligence to identify codes by applying coding guidelines, payer rules edits, medical necessity and other policies that support accurate coding.
• Uses AMA (American medical association) licensed CPT data for higher levels of coding compliance.
• Quickly adjust to regulatory changes to ensure accurate billing.
• Have the ability to create custom edits.
• The ability to cover and support the spectrum of him coding areas for hospital and professional records on a single platform to include emergency room, outpatient clinic and procedure accounts, day surgery and professional clinic accounts; please list all record types your autonomous coding solution can process accurately.
• Include quality assurance auditability with extensive reporting and analytics.
• Provide on-going engine training and learning based on historical and current coded data to identify improvements in performance over time.
• The system or solution should be capable of providing the initial properly sized capacity of service to meet runtime requirements.
• The system or solution should also be capable of providing monitoring and alerting as to capacity, security and performance alarms into standard monitoring systems approaches.
• The system or solution should be flexible and scalable to expansion of services and resources as needed, when the solution requires additional resources for proper runtime operation in its service life.
• Remote / Cloud Based providers as asked to deliver a full and comprehensive manifest of their current disaster recovery, availability and multi-site recovery models in practice as of the contact, to meet a 24x7x365 operational runtime expectation, given our obligations to the communities we serve.
• The systems or solution must support IPv4 and IPv6 addressing methods.
• The systems or solution must support networking load balancing modalities, proxy server methods and standard security equipment and filtering techniques, such as proxy services forward and reverse configurations.
- Small Platform Solutions (on premises)
• Microsoft windows 7 and 10 common desktop platforms, laptops, tablets and appliances.
• Some Linux based desktop and laptop installations of note, primarily red hat, centos, Ubuntu or SUSE.
• Some Linux based appliance virtual machines and physical devices, varying degree of Linux OS using the distributions above or in some cases a custom distribution by the vendor, who supports this OS and platform.
• Specific patient care and point of care devices that provide varying services and operations for specific clinical areas; some of these devices are network or internet enabled as well; specific detail on this class of devices can be requested as needed.
- Mobile Devices and IoT (on premises & cloud)
• Apple© iPad, iPhone and Apple Watch© devices.
• Android© based tablets and cellular phones, watches.
• Microsoft© Windows based Surface Tablets.
• Various specialized healthcare appliance devices and solutions for point of care delivery of service.
These devices utilize their own vendor provided / custom firmware and or RTOS.
• Various IoT devices in this class are becoming more prevalent as well in our environment. Again, these are custom firmware or RTOS solutions with standard TCP/IP stack and or Bluetooth capabilities.
• Physical and or data center SCADA solutions that incorporate physical network connected services as well as IoT remote devices for alarm management, alerting or detection. Again, these devices would contain custom firmware or RTOS and operate with a standard TCP/IP stack and or Bluetooth capability.
• Specialized service delivery devices such as Food delivery, menu selection and food storage systems that incorporate tablets or mobile devices, including IoT functionality as well for the major appliances or systems hosts.
• Specialized service delivery devices for the storage and delivery of medications and medical equipment. In this space, a Windows© OS is common for the device or specialized firmware and or customer RTOS. These often include IoT devices as adjuncts or ancillary device enablers which again utilize common TCP/IP stacks and or Bluetooth for communications.
• Personnel Badge and Area Access cards or key fobs. These include solutions where NFC and Bluetooth are common as well as standard proximity coil solutions.
• Standard wireless telephony solutions that are backboned from our network infrastructure or cellular
- Contract Period/Term: 2 years
- Questions/Inquires Deadline: March 21, 2025