CASE STUDY

Inova's Autonomous Medical Coding Success Story

See how Inova saved $1.3M in annual coding costs, increased charge capture by 10%, reduced DNFB volume by 50%, and supported its medical coding team with Nym.

The situation

Navigating the Pressures of High ED Volumes and Workforce Shortages

Inova is the leading nonprofit healthcare provider in Northern Virginia, serving over four million patients annually across its expansive network of hospitals, specialty practices, and outpatient facilities. Over 500,000 of these visits occur in Inova's emergency departments, including the third-busiest ED in the entire country at Inova Fairfax Hospital.

These high ED volumes, combined with industry-wide medical coder shortages and complex ED coding workflows, forced Inova to rely on expensive contract coders and overtime requirements. Still, the organization found itself facing high Discharged Not Final Billed (DNFB) volumes and coding backlogs.

These challenges led Inova to search for a medical coding solution capable of alleviating administrative burdens for its in-house coding team, eliminating reliance on expensive coding practices, and accelerating payment cycles.

What led Inova to explore autonomous coding?

Administrative burden: Overtime requirements for in-house coders and limited PTO led to a work-life imbalance.

Expensive medical coding practices: Reliance on expensive contract coders and overtime requirements for in-house coders drove up coding costs.

Delayed payment cycles: Unable to keep up with high ED volumes, Inova experienced high DNFB volumes and coding backlogs that ultimately delayed cash flow

The SOLUTION

Implementing Nym's Autonomous Medical Coding Engine for ED Facility Coding

After assessing several medical coding solutions, Inova selected Nym as its preferred partner and deployed Nym's autonomous medical coding engine for ED facility coding.

Deployment details:

 Specialty: Emergency Medicine

 Product type: Autonomous coding and partial coding (facility only)

   Footprint: Deployed at 5 hospitals and several outpatient emergency care centers

The IMPACT

Delivering True Operational and Financial ROI

   $1.3M reduction in annual ED medical coding costs

• Inova has achieved significant cost savings by removing OT requirements for in-house coders and eliminating the need for expensive contract coders. The health system also achieved additional cost savings by implementing Nym's partial coding product.

   50% decrease in weekly revenue sitting in ED DNFB

• Inova reduced its ED coding backlog by 48% almost immediately after implementing Nym's engine, enabling its coders and Nym's engine to focus on current encounters. The health system also decreased the weekly delayed revenue associated with ED DNFB volumes by an average of 50%, thereby accelerating payment cycles.

 10% increase in average revenue per ED encounter

• While not a main goal of implementing autonomous coding, Inova's average revenue per ED encounter has increased by over 10% since going live with Nym. This increase is attributed to Nym's engine capturing more bedside procedures, capturing more Evaluation and Management (E/M) level 4's and 5's, and being more consistent with injections and infusions coding and charge capture.

   Eliminated mandatory OT and limited PTO for medical coders

• Inova has removed all OT requirements and no longer has to limit PTO for its in-house coders, significantly improving work-life balance. Additionally, Inova promoted four ED coders to higher-complexity areas shortly after going live with Nym.

WhAT's next for Inova?

Expansion into New Specialty Areas

Inova's implementation of Nym's autonomous medical coding engine has directly addressed their core objectives of eliminating administrative burdens, reducing coding costs, and accelerating payment cycles.

Building on this ED-focused success, Inova plans to expand autonomous coding to additional specialty areas, including outpatient visits and outpatient surgery. This strategic expansion has further cemented Inova's position as a leader in healthcare innovation within Northern Virginia and beyond, serving as a proven model for how large health systems can successfully leverage advanced technology to address persistent medical coding challenges across multiple service lines.