As hospitals face continued financial pressures, including rising costs and declining reimbursement rates, they are seeking tools that not only improve efficiency but also increase revenue.
MercyHealth seems to have found a tool that accomplishes both feats for its health system.
The system, based in northern Illinois and southern Wisconsin, has six hospitals and 85 primary and specialty care clinics. In 2023, it started using Arintrawhich uses AI to automate coding and identify missed reimbursement opportunities – and since then, Mercyhealth said it has seen a 5.1% increase in revenue.
Arintra’s system is designed to accurately code thousands of patient records without human review.
“It reads unstructured clinical language, interprets the nuances in how different providers document, and applies complex coding logic in real time,” explained Nitesh Shroff, CEO of the startup.
The platform then converts this information into medical codes and writes them back into the EHR for immediate request submission.
Mercyhealth has implemented Arintra’s solution at 37 sites, a combination of clinics and hospitals. The health system uses the tool in 10 specialties: family medicine, internal medicine, urgent care, pediatrics, cardiology, radiology, gynecology, gastroenterology, endocrinology and hospitalist.
Kelly Pierson, director of coding and clinical documentation integrity at Mercyhealth, noted that Arintra’s platform came out on top after the health system conducted an “in-depth” vendor comparison that looked at capabilities, product roadmaps and implementation requirements.
“Arintra stood out because they took the time to understand how we operate. We have our own business rules, requirements and payer-specific policies. Arintra configured the platform to match our coding approach. From the start, it felt like a partnership, and that mattered to us,” Pierson said.
Before adopting Arintra’s platform, Mercyhealth coders were only able to review about 30% of records due to volume constraints, leaving the health system vulnerable to coding gaps and missed revenue, she said.
Arintra now handles high volume routine coding. This way, graphics are coded more accurately and submitted more quickly, Pierson said.
“At the same time, with our coders freed up, they can focus on denial analysis and revenue integrity projects. Arintra has also helped us provide more targeted training to our vendors by identifying gaps in documentation, which has allowed us to improve the quality of documentation over time,” she noted.
Mercyhealth also reduced its accounts receivable days by approximately 50% after adopting Arintra’s software. Before implementation, the system averaged about 14 days in A/R, and currently that figure is seven days or less, Pierson said.
She said Mercyhealth’s Arintra deployment shows how automating routine coding can ease pressure on overburdened teams while helping health systems protect revenue as reimbursement levers tighten.
Photo: Witthaya Prasongsin, Getty Images