TruBridge Encoder and TruBridge Encoder Essentials

Our client, TruBridge (formerly TruCode), is one of the top providers of medical record encoders in the U.S. The company aimed to create a healthcare solution that would facilitate the job of medical coders and reduce coding errors.

Among the main issues were:

• inefficient coding process
• human errors
• insurance claim denials due to coding mistakes

To address these challenges, the client partnered with EffectiveSoft to develop the TruBridge Encoder application for desktop from the ground up. The next project stage included expanding the solution capabilities and moving it to the cloud.

Our team developed a solution that allows medical coders to review clinical statements and assign standard codes to the diagnosis and treatment provided to the patient according to the existing international classification. The system automatically calculates care costs and reimbursement based on the codes, streamlining insurance claims processing, ensuring accurate billing, and enabling efficient record-keeping.

The desktop version of the product, TruBridge Encoder, effectively assists healthcare information professionals, increasing coding accuracy and productivity.

TruBridge Encoder Essentials is a cloud version of the TruBridge software that operates on HIPAA compliant cloud storage services from Microsoft. It has all the benefits of the desktop application and can be integrated with the medical software solution in place. The user interface components of TruBridge Encoder Essentials can be individually embedded into any medical software that displays HTML content such as EHR (electronic healthcare record).

With this solution, users can perform the following tasks:

• Edit inpatient and outpatient claims with MCE (Medicare Code Editor), OCE (Outpatient Code Editor), NCCI (National Correct Coding Initiative), Medical Necessity, and proprietary TruBridge edits. Examine alternative DRGs (Diagnostic Related Grouping) for claims through Principal Diagnosis or DRG Analysis.
• Calculate the grouping and pricing of claims with DRG, APC (Ambulatory Payment Classification), ASC (Ambulatory Surgery Center), and EAPG (Enhanced Ambulatory Patient Groups).
• Import and export patient records.

Additionally, the solution offers the following capabilities:

• Displaying coding-related references in the official documents and articles.
• Researching additional information applicable to the selected code.
• Searching for necessary information by terms, codes, or even synonyms within the specified code sets.
• Generating detailed productivity-focused reports.

With the solutions we built, healthcare facilities can benefit from improved coder productivity and more accurate coding, reducing the number of reimbursement denials and enhancing regulatory compliance.

Currently, the EffectiveSoft team continues to work on the project, focusing on migration of the application to the web and a comprehensive system redesign with the aim to transform user experience, improve efficiency, and streamline workflows. This includes adopting a new design system and adding new features, ensuring usability and consistency across product versions.