/case-studies / healthcare-ai-medical-coding
GENERATIVE AI & COPILOTS

AI-assisted medical coding cuts claim denials

client
Healthcare Provider
industry
Healthcare
services
Generative AI · Governance
duration
6 months
fig.20// skillikzEHRtriageclaimscarecare.metricsrollout87%-30%no-showsusage91coveragelive
// OVERVIEW

Healthcare Provider — a healthcare organisation — engaged Skillikz on ai-assisted coding: GenAI that drafts accurate codes for clinician review. This case study sets out the business challenge, the AI-led approach we took, the technologies involved and the measurable outcomes delivered over 6 months.

// TECHNOLOGIES
RAGClaude / GPT-4Next.jsPythonVector DBAzure OpenAI
-28%
claim denials
coder throughput
human
validated
audit
trail
01 // THE CHALLENGE

Manual medical coding was slow and error-prone, and coding errors drove costly claim denials and rework.

02 // OUR APPROACH

We built an AI assistant that drafts codes from clinical notes for coder validation, grounded and fully auditable.

Grounded code suggestions from notes
Coder validation and override
Confidence scoring and guardrails
Full audit trail for compliance
03 // THE RESULTS

Claim denials fell 28% and coders work faster, with humans validating every code and a complete audit trail.

Accuracy up, denials down, and our coders are doing judgement work, not lookup.

Revenue Cycle Director · Healthcare Provider
// HOW WE'D DELIVER THIS TODAY

The AI services behind this outcome

A project like this draws on a focused set of Skillikz services — from first assessment to a working pilot and a clear path to scale.

// MORE WORK
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