Tampa General Hospital (TGH) today announced that, a two year relationship with MilagroAI, a leader in autonomous medical coding, facilitated by TGH Ventures, has generated transformative results in real-time automated coding of surgeries.
“Tampa General is using Milagro’s platform to capture millions of dollars in revenue that may have gone unrealized, while maintaining the highest quality billing and coding operations possible. Milagro has demonstrated accuracy levels of 95 percent in real-time coding of surgical information, and we plan now to continue working together to expand their capabilities across multiple coding areas,” stated Rachel Feinman, Vice President of Innovation at TGH and Managing Director of TGH Ventures.
“Health systems continue to have workforce challenges, particularly with a shortage of expert surgical and other medical coders, making complex coding an area ripe for automation,” she continued.
“TGH is one of the earliest and most significant partners for Milagro, and Milagro’s innovative use of AI to improve the accuracy and timeliness of surgical coding has resulted in significant revenue capture that would have likely been denied otherwise,” said Diane Lerch, Division Director of Coding and Clinical Documentation Improvement at TGH. “It has been so successful that we are expanding its use into our Ambulatory Surgical Centers and the three hospitals in our TGH North division.”
For surgeries that require a clinically appropriate change in surgical plan while a procedure is in progress, payors require a change request – often on the same day – for the surgical reimbursement code. Many health systems, including TGH, have difficulty performing this adjustment in the required same-day timeframe. These procedural and data-entry challenges create negative financial impact due to high reimbursement denial rates or ‘down coding’ reimbursement.
Together, the companies were successful in utilizing real-time data from TGH to improve and implement the Milagro coding algorithms and optimize related workflows. TGH is in the process of expanding the use of the Milagro surgical billing platform across all specialties and fully integrating it into its Electronic Health Records (EHR) across its surgical operations.
“TGH was able to immediately see the value we brought versus any other product or company in the market and work quickly with us to validate and improve our unprecedented results. We are very excited to now team with TGH to build on our success together to date, and to further expand our capabilities to solve the most difficult and expensive problems in Revenue Cycle Management coding,” said Amit May-dan, CEO of MilagroAI. “We look forward to announcing more capabilities very soon,” he added.
