Metacognition LLC
Metacognition LLC delivers innovative software solutions and services for web-based clinical data analytics, medical artificial intelligence, and medical terminology systems engineering. Our products and services draw from decades of award-winning experience in medical information system architecture and integration, medical terminology engineering, and international data standards.
Home Case Mixer
Home Case Mixer is a clinician-friendly tool that helps Home Health Care agency providers, either directly or within their EHR system, accurately determine and record the proper case mix and maximize reimbursement for care provided based on the Patient-Driven Groupings Model (PDGM), Medicare’s payment system for home health agencies.It provides the most thorough case-mix analysis available for a given list of ICD-10 codes or an OASIS assessment, including contextual details and comorbidity analyses. It converts the billing process from a passive, recording exercise into an active strategy to capture every legitimate and accurate dollar of reimbursement and relevant condition.
Coding Expert System
Upload a clinical PDF (an H&P, for example) and receive an ICD-10-CM code list resolved against the medical terminology and extracted by a state-of-the-art medical terminology expert system.Find groups of codes within comorbidity gaps identified by Home Case Mixer, whose interactions with the problem list would result in an adjustment to the case-mix.Perform Quality Assurance (QA) via real-time cross-reference of the problem list against official CMS and NCHS ICD-10-CM guidelines.No Black Boxes: Every code selection is audit-ready and cites the original text in the source document that supports it, along with the rationale of the terminology expert system in adherence to the best principles of explainable Artificial Intelligence (AI) in healthcare
Care Planning Assistant
Map a patient's (analyzed) PDGM case-mix problem list to international nursing standards of care and the tracking of their outcomes, generating a risk-prioritized framework for a care plan that a nurse case manager can build out and use.Aligning the care plan with the case-mix profile ensures the agency isn't just coding for money but is also ready for immediate use in Quality Assurance and Performance Improvement (QAPI) programs and oriented towards the specific outcomes that trigger Value-Based Care bonuses.