Seemingly simple coding errors can quickly snowball, disrupting clinical workflows and contributing to significant revenue loss over time for provider organizations. A study published in BMC Health Services Research found that coding errors were present in 89.4% of audited patient medical records, while a study from the Journal of the American Medical Informatics Association (JAMIA) found that clinics can experience a 10 to 30 percent decrease in revenue due to coding errors alone, totaling up to $125,000 per year in losses.
Many health systems focus on denial management, but this simply drains resources. In fact, more than three-quarters of healthcare leaders deemed denials management the most time-consuming revenue cycle management (RCM) task in 2024. Instead, provider organizations should focus on denial prevention—and that starts with optimizing clinical workflows.
When coding errors and inefficient processes persist, they create a ripple effect that drains revenue and increases rework burden. By embedding a real-time solution like IMO Core directly into the electronic health record (EHR), clinicians, billers, and coders can address claims at risk of denial or partial reimbursement at the moment of documentation.
Read our latest insight brief for all the details or stay on this page for three ways to reduce denials and maximize ROI through better workflows.
1. Eliminate errors in clinical workflows with real-time coding intelligence
Problem: Coding errors—like unspecified laterality or unacceptable primary diagnoses—trigger denials, increase rework, and disrupt clinical workflows.
Solution: IMO Health’s real-time coding solution (IMO Core) translates coding and payer logic into clinician-friendly language, flagging errors at the point of care and prompting timely corrections.
Outcome: Fewer coding queries, less rework, more efficient workflows.
2. Patch documentation gaps before they start leaking revenue
Problem: Incomplete or inconsistent documentation leads to claim denials and delayed reimbursements. To this end, IMO Health analyzed 39 million patient encounters and found that 25% of them were documented with codes that could have been refined to be more specific.
Solution: Smarter documentation workflows ensure that critical coding details are captured the first time around. EHR-integrated, automated prompts also assist providers, reducing back-and-forth with coders.
Outcome: Fewer documentation errors, fewer claim rejections.
3. Refine provider workflows and safeguard ROI with AI-powered insights
Problem: Most provider organizations analyze claim denials too late, leading to reactive corrections.
Solution: A clinical AI-powered solution like IMO Core spots problematic claims before submission and improves clinical operations continuously.
Outcome: Proactive documentation adjustments, higher revenue potential.
Ultimately, fewer coding errors will lead to more streamlined workflows, more streamlined workflows will lead to fewer claim denials, and fewer claim denials will lead to higher revenue. Pretty simple, right?
