Profile

CodaMetrix’s mission is to make high-quality and consistent medical coding affordable, reliable, and applicable across revenue cycle, clinical, and research cycles. The company aims to remove doctors from the coding process and transform the complex reimbursement process into an efficient adjudication experience using AI and automation.

Founded in 2019, CodaMetrix consists of healthcare, technology, revenue cycle management, and data science experts. The company’s multi-specialty autonomous medical coding platform uses AI to continuously learn from and act upon clinical evidence in the EHR. This platform autonomously translates clinical notes into billing codes that meet coding requirements, ensuring that claims consistently represent the complete episode of care. By reducing human coding and provider workload, CodaMetrix improves the efficiency and quality of medical coding.

Visit www.codametrix.com

Key Products

CodaMetrix is the first multi-specialty autonomous coding platform uniquely designed to save time by aggregating disparate pieces of clinical information found across the EHR to provide high quality autonomous medical coding. Top service lines include radiology, pathology and endoscopy. Products include:

• CMX Automate™ is an ultra-secure, cloud-based, medical coding AI platform that securely plugs into a client’s existing network that does not require coder training or changes to the coding workflow. Compared to manual coding, CMX Automate™ reduces denials by 70% and coding costs by at least 30%.


• CMX Amplify™ is a coding decision support tool, embedded in the EHR to help code cases more efficiently, harnessing the power of predictions, to reduce denials by 70% compared to manual coding. Coders can launch the tool with any case to view predicted codes or select from alternative codes.


• CMX Longitudinal Store (LS)™ consolidates, aggregates and structures data from disparate sections of the EHR providing a comprehensive view of a patient’s medical history (i.e., clinical notes, patient demographics, orders & results). This holistic view of a patient’s timeline and clinical data is critical in enabling efficient and accurate coding.

Key Executives

Hamid Tabatabaie, CEO & President, has been at the forefront of innovation in medical informatics for over 30 years. His vision, leadership, experience, and insight have helped launch and grow several successful startups in the Healthcare Information Technology (HIT) field. Prior to CodaMetrix, he was the Founder and CEO at lifeIMAGE, the most utilized cloud-based service for the exchange of diagnostic imaging information. He was also the first CEO at AMICAS and took the company from concept to a leader in image management within 4 years. He started his entrepreneurial career in 1993 as the Founder and CEO at Systems Concepts (SCA), a fast-growing HIT implementation consultancy firm. Currently, he serves as Board Member and Advisor to several technology start-ups and not-for-profits.

Jay Aslam, PhD, Chief Data Science Officer oversees all Artificial Intelligence, Machine Learning, and Natural Language Processing at CodaMetrix. He was part of the team that developed Massachusetts General Brigham’s original medical coding AI system in 2016. Jay is also a Professor at Northeastern University where he most recently served as the Senior Associate Dean for Academic Affairs in the Khoury College of Computer Sciences. Jay received his Ph.D. in Computer Science from MIT, with a focus on machine learning and noise-tolerant computation.

Tara Bradley, Chief Customer Officer has 20 years of experience in scaling operations and building out teams in technology and healthtech companies, with a focus on revenue cycle management solutions.

Chris Gervais, Chief Technology Officer oversees the company’s core software engineering, data and analytics, and AI and machine learning teams. He brings extensive experience in healthcare technology and scaling companies through executive leadership roles at Janus, Kyruus Health, lifeImage, and Mass General Brigham (formerly Partners Healthcare).

Lindsey Reilly, Vice President of Product Management is well-versed in the critical intersection of healthcare delivery and financial management with roots as a Registered Nurse and a deep understanding of healthcare revenue cycle and compliance operations. Her experience includes roles spanning from direct care delivery and project management, to ownership and mitigation of regulatory billing, coding and quality audits. Prior to transitioning into the product space with CodaMetrix in 2022, she was the Compliance Director at Massachusetts General Hospital.

Lisa Morella, MBA, Senior Vice President of Data & Analytics leads data intelligence and machine learning engineering teams. With over 15 years at Mass General Brigham, she spearheaded enterprise-wide data platform initiatives and drove a 400% increase in Tableau platform adoption. With extensive experience in data governance, security, and analytics, Lisa has been instrumental in aligning CodaMetrix’s artificial intelligence and machine learning capabilities to meet the complex needs of healthcare organizations and transform their revenue cycles.

Robin Lloyd, Chief Operating Officer leads the product, operations, customer success, and marketing teams at CodaMetrix. He brings over 20 years of experience delivering rapid growth and scale; building inclusive, high-performing teams; and taking innovative solutions to market across multiple industries and geographies. Prior to joining CodaMetrix, Robin led product and operations teams at Spring Health, a leading provider of precision mental healthcare to employers and health plans, helping deliver high-availability, highly personalized care to >10 million covered lives. Robin previously served as Chief Commercial Officer for Health Fidelity, a leading NLP-powered risk adjustment solutions provider, and spent 8 years at Nuance, leading the clinical documentation solutions business that served >50% of all practicing physicians in the US.

Customer Insights

“Through the adoption of CodaMetrix we have been able to reach unprecedented levels of automation that have had efficiency & cost reduction ripple effect across our entire organization.” – Kim Davis, Sr. Director, Revenue Services University of Colorado Medicine

“Our turnaround time is dramatically different with the assistance with CMX: 4.82 days versus 43.6 and CMX has coded enough work that it would have taken a full FTE a year to code what it has mastered.” – Tammy Bickle, Director, Revenue Cycle, Oregon Health and Science University

“It was the best ‘go-live’ implementation of an application we’ve experienced to date. CodaMetrix worked hard to understand our needs and processes in order to provide a seamless transition on day 1, with no surprises and no changes to our existing workflow.” – Kristie Janvrin, Associate Director, Coding and Ancillary Services, Mass General Brigham

“Certainly the ability to cover additional volume and grow [as a result of CodaMetrix] has been huge in our current financial environment. A reduction in AR base – your AI doesn’t take vacation or holidays, all of those things where we build backlogs – has allowed Henry Ford to keep up with higher volumes. Joann Ferguson, VP Revenue Cycle, Henry Ford Health System

Investors

CodaMetrix’s AI Platform Now Available in Epic Toolbox to Transform $20B Medical Coding Sector, August 2024: The CodaMetrix AI Platform achieved Epic Toolbox designation for the fully autonomous coding category. Toolbox features products that meet Epic’s recommended integration practices (“Blueprint”) for the product type. “Medical codes are intended to be a codified representation of patients’ clinical history, but current coding practices often stop at meeting reimbursement rules because today coding at the optimal level of detail is expensive to do manually. CodaMetrix uses AI to reduce cost and improve quality in the predominantly fee-for-service settings. We’re honored to be selected by #1 ranked health systems in 14 states, 4 health systems ranked in the top 5 in other states, and the largest radiology group in the U.S.” said Hamid Tabatabaie, CEO of CodaMetrix (Read).

CodaMetrix Announces $40M Series B Financing to Advance Medical Coding Quality and Clinically Enrich Claims Data Through AI, March 2024: Transformation Capital led the financing with continued support from existing investors SignalFire, Series A lead, and Frist Cressey Ventures. Todd Cozzens, Co-Founder and Managing Partner at Transformation Capital, joined CodaMetrix’s Board of Directors. Series B financing will be used to further advance CodaMetrix’s AI-powered solutions which improve medical coding quality, produce clinically comprehensive data sets, reduce the overall cost of care, and alleviate administrative burden on providers (Read).

Competitors

• Fathom


• Nym

Corporate Responsibility

CodaMetrix is a team of technology, healthcare, and revenue cycle experts committed to developing AI-powered solutions aimed at reducing physicians’ administrative burden. When existing Computer Assisted Coding (CAC) and rules-based NLP solutions failed to meet their needs, the physician organizations at Mass General Brigham set out to create their own solution: CodaMetrix. Founded in 2019, CodaMetrix was established to refine and commercialize the CAC solution originally developed by the Massachusetts General Physician Organization’s Physician Billing Office, which had been used to code cases across multiple specialties.

The company’s mission is to make high-quality, consistent coding affordable, reliable, and applicable across revenue cycle, clinical, and research cycles. CodaMetrix aims to get doctors out of the coding business and transform the complex reimbursement process into an efficient adjudication experience using AI and automation.