TITLE: Cleveland Clinic Adopts AI for Medical Coding Efficiency

Cleveland Clinic has partnered with technology firm AKASA to deploy generative AI tools aimed at automating routine medical coding tasks, a move designed to enhance operational efficiency and improve patient experiences in healthcare revenue cycles.

Medical coding involves translating patient care documentation into standardized codes essential for billing, reimbursement, reporting and record-keeping. This process, particularly in the mid-revenue cycle, ensures accurate representation of treatment complexity to support continuity of care and clinical decisions across providers.

Nicholas Judd, senior director of revenue cycle management and health information management at Cleveland Clinic, described the integration as a response to evolving demands in the field. "As medical coding evolves, there are increasing opportunities to automate routine tasks that don't require human input, allowing coders to focus more on those tasks that truly benefit from human judgment," Judd said. "This helps us clearly distinguish between what can be automated and what needs a personal touch."

The coding workflow at Cleveland Clinic typically requires revenue cycle teams to examine over 100 clinical documents per patient case, including progress notes, discharge summaries and pathology reports. Coders then select appropriate codes from a pool exceeding 140,000 options, a task that can consume up to an hour for a single encounter.

Gina DeFranza, director of coding and reimbursement at the institution, emphasized the patient impact of accurate coding. "Correct coding facilitates access to necessary services. It helps ensure that prior authorizations are approved and that patients don’t face unnecessary barriers to receiving care," DeFranza said. "When coding is inaccurate or incomplete, it can result in miscommunication or delays that negatively affect the patient’s experience."

Judd highlighted additional risks of errors, including inaccurate patient outcomes, insurance processing delays, unexpected charges and denied claims. "Accurate and properly coded documentation helps prevent errors that could lead to these issues," he said. "This contributes to providing safer, more effective care, a smoother financial experience, and reduces administrative burdens for patients, coders and providers."

Selection Process and Partnership

The decision to adopt AI tools stemmed from a thorough evaluation involving input from Cleveland Clinic's strategy office, digital teams and revenue cycle management. Judd noted that the selection process focused on identifying solutions capable of navigating the complexities between patient care and billing.

The partnership with AKASA introduces generative AI specifically tailored to assist in medical coding practices. This collaboration seeks to boost efficiency, accuracy and the quality of patient care through advanced automation of routine elements.

Healthcare revenue cycle management remains a highly regulated and complex domain, Judd observed. "Sophisticated tools like generative AI are essential to keep pace with the rapid changes," he said. "The challenge is managing expectations—balancing the hype with the reality of AI capabilities."

Early Outcomes and Future Implications

Initial implementation has yielded positive results. DeFranza reported improvements in speed and accuracy over previous workflows. "By automating routine tasks, we’re freeing up caregivers to focus on more complex work that leans on their clinical expertise and critical thinking," she said.

Judd reinforced the broader benefits, stating that streamlined coding supports continuity of care, patient safety and quality outcomes. It also minimizes friction in processes like prior authorizations and payer denials, keeping care delivery at the forefront and enhancing the overall patient experience.

Looking forward, both executives anticipate that shared learnings and proven successes will propel further innovations in the revenue cycle industry. As health systems face mounting pressures to optimize operations, such AI integrations represent a strategic step toward balancing technological advancement with human oversight in critical healthcare functions.

The adoption aligns with wider trends in health information technology, where automation is increasingly leveraged to address time-intensive tasks without compromising accuracy or regulatory compliance. Cleveland Clinic, a nonprofit academic medical center, continues to explore digital solutions to support its mission of delivering high-quality care.