Hybrid human and computer-assisted coding workflow

A system comprising at least one non-transitory computer-readable medium storing computer program instructions executable by at least one computer processor to perform a method, the method comprising:

• (A) receiving, by a chart routing module executed by the at least one computer processor, data representing a medical chart, wherein the chart routing module is configured to perform one or more routing determinations on the data;
• (B) determining, by the chart routing module, whether the medical chart qualifies for automated processing by a computer-assisted coding (CAC) module, wherein determining whether the medical chart qualifies for the automated processing comprises one of:
• determining whether the medical chart comprises scanned handwritten notes;
• and
• determining whether the medical chart has a high confidence of being coded accurately by the CAC module;
• (C) in response to determining that the medical chart qualifies for the automated processing by the CAC module:
• providing, by the chart routing module, the medical chart to the CAC module;
• performing CAC, by the CAC module, on the medical chart to produce an initial set of billing codes automatically;
• receiving, by the chart routing module, the initial set of billing codes from the CAC module;
• determining, by the chart routing module, whether a skill value associated with an initial reviewer exceeds a particular value;
• providing, by the chart routing module, the initial set of billing codes to the initial reviewer in response to determining that the skill value associated with the initial reviewer exceeds the particular value;
• receiving, by the chart routing module, from the initial reviewer, a modified set of billing codes and modified code assessment data that represents an assessment of accuracy and completeness of the modified set of billing codes;
• and
• providing, by a coding output routing module executed by the at least one computer processor, a final coding output for a final review, wherein the final coding output comprises the medical chart, the modified code assessment data, and the modified set of billing codes, and wherein providing the final coding output for the final review results in correctness of errors in the modified set of billing codes received from the initial reviewer and increase in efficiency of a coding process, which lead to increase in accuracy of the final coding output and reduction in costs associated with the coding process;
• and
• (D) in response to determining that the medical chart describes a complex medical procedure:
• providing the medical chart to the initial reviewer;
• receiving the initial set of billing codes from the initial reviewer;
• and
• providing the initial set of billing codes for the final review, wherein providing the initial set of billing codes for the final review results in correctness of errors in the initial set of billing codes.