Revenue Cycle Management

Revenue cycle management solutions company CodaMetrix has closed a $40 million Series B funding round to create AI solutions that improve medical coding quality. Founded in 2019, CodaMetrix’s CMX platform was built in partnership with Mass General Brigham to provide real-time audit capabilities and seamless EHR integration, which are used as a feedback loop to continuously improve AI learning. The software-as-a-service platform uses machine learning, deep learning, and natural language processing to continuously learn from, and act upon, the clinical evidence stored in electronic health records (EHRs). As a multi-specialty platform that classifies codes across radiology, pathology, surgery, gastroenterology, and inpatient professional coding, Boston-based CodaMetrix said it is the first platform to have an impact across departments by alleviating administrative burdens from billing staff. On average, CodaMetrix said, providers using the CodaMetrix platform experience a 60 percent reduction in coding costs, 70 percent reduction in claims denials, a 5-week acceleration in time to cash, and improvements in provider satisfaction, quality and compliance. The company has partnered with several health systems – including Mass General Brigham, University of Colorado Medicine, Mount Sinai Health System, Yale Medicine, Henry Ford Health and the University of Miami Health System. “Medical coding is one of the most time-consuming, understaffed and inherently error-prone parts of the health system revenue cycle. Hospitals face a high demand on human and financial resources and clinicians must often work through tedious, administrative processes away from patient care,” said Hamid Tabatabaie, CodaMetrix president and CEO, in a statement. “Our game-changing AI platform delivers vital automation which not only addresses these pain points but, more significantly, changes claims data from notoriously unreliable to clinically valuable. We are proud to serve leading provider organizations with a comprehensive and transformative automation solution, setting the standard for coding quality as part of our vision to change healthcare through the use of AI.” The company’s Series A funding was led by SignalFire. Frist Cressey Ventures (FCV), Martin Ventures, Yale Medicine, University of Colorado Healthcare Innovation Fund, and Mass General Brigham physician organizations also participated in the round. The Series B was led by Transformation Capital with continued support from existing investors SignalFire, Series A lead, and Frist Cressey Ventures.