HIPAA-Compliant Patient Intake & Coding
Automating clinical data capture and insurance coding securely.
The Client's Problem
A large US multi-clinic healthcare group faced severe administrative backlogs due to patient intake form processing. Administrative staff manually transcribed patient demographics, clinical symptoms, and medical histories from faxed or scanned paperwork into their Epic EHR platform. Transcribers frequently miscoded complex procedures or diagnoses, leading to a 12.4% error rate in ICD-10 coding. These coding errors caused delays in insurer review cycles and high insurance claim rejection rates, tying up clinic cashflow.
Our Engineered Solution
We developed a secure, HIPAA-compliant clinical parsing pipeline. The system processes intake documents using regional, private cloud LLMs, extracts clinical text, maps history to ICD-10 diagnoses codes via a semantic vector database, and automatically prepares prior authorization forms to send to insurance gates.
How We Did It
HIPAA-Compliant Infrastructure Design
We established a secure, isolated private cloud network that complies with HIPAA specifications. All PHI data is encrypted in transit and at rest, ensuring that no patient health information leaks to public API logs.
ICD-10 Semantic Search Vector Database
We indexed over 70,000 ICD-10 medical coding terms into a high-speed vector search database. The pipeline parses doctor notes and symptoms from intake forms and performs a semantic search to recommend the exact coding schema.
EHR Interface & Prior Authorization API
We built a secure API link connecting the parsed data to Epic EHR. Clinic operators validate coding suggestions in a custom UI, and the system automatically compiles and submits prior authorization requests to insurance portals.
Operational Impact
Intake coding error rates plummeted from 12.4% to under 0.2%. Prior authorization approval rates increased by 40%, administrative overhead dropped by 75% as transcribers shifted to single-click validation, and average claim reimbursement cycles were accelerated by 18 days.
5 Weeks
Compliance & Accuracy Rate
Administrative Overhead
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