Montecito Medical™ has established Calm Waters AI, a sister company offering an AI-powered Evaluation and Management (E/M) coding solution that increases revenue for healthcare providers by improving coding accuracy, saving time, reducing denials and decreasing the likelihood of coding audits.
Calm Waters AI joins a growing platform of AI-driven solutions powered by Montecito that enable physicians and provider groups to increase revenues, decrease costs and build wealth.
“Our company has always been guided by a simple, overarching philosophy,” said Chip Conk, CEO of Montecito Medical: “Physicians take care of everyone. Montecito takes care of physicians. We have built a reputation over the past 15 years for helping providers make the most of their opportunities in medical real estate. Calm Waters reflects the growing number of ways we are ‘taking care of physicians’ through technology solutions that help them build stronger practices and better serve patients.
“We are particularly excited about Calm Waters because it addresses challenges that directly affect every provider’s bottom line. It is nothing short of a breakthrough in defensive E/M coding.”
E/M coding, an essential process providers use in support of medical billing, is primarily done manually by staff today. Manual coding is time-consuming and exposes each medical record to unaided, subjective interpretation by coders — resulting in under-billing and reduced reimbursement along with inconsistencies that increase payer denials and audits.
“Providers face a severe shortage of coding staff,” said Joe Ferro, President of Calm Waters AI, who possesses nearly 25 years of experience in healthcare information technology, coding and revenue cycle management. “In fact, there are currently 15 openings for every qualified coder, and 60 percent of each coder’s time is spent on E/M leveling. Calm Waters levels a chart in milliseconds, and with greater accuracy than a human. Through this platform, providers can bring order, compliance and standardization to a costly and difficult process. The bottom-line result is increased revenue through reduced coding time, reduced audit risk and fewer denials.”
Depending on the specialty, Ferro noted, a 1% decrease in denials and resubmissions would create a return on investment (ROI) between 7.2-to-1 and 9.3-to-1. A reduction in documenting time of just two minutes would produce ROI between 32-to-1 and 36-to-1.
The company has recently partnered with athenahealth Marketplace to integrate Calm Waters AI into one of the nation’s most widely used electronic medical records (EMR) platforms.
Among the other AI-driven technology solutions already in use by providers are Winnow, which supercharges clinical recruitment to target best-fit candidates; Polaris, which optimizes staff scheduling to reduce labor costs and clinician burnout; and Scout Insight, which enables providers to identify service gaps for their specialty in submarkets and to pinpoint optimal locations for satellite facilities.
