Medical coding is an unavoidable part of healthcare delivery. Coding is essential for accurate documentation, billing and reimbursement in healthcare — yet many providers still rely on manual coding practices that eat up staff members’ time.
On Tuesday, Nym raised $47 million to help solve this problem. The New York City-based startup announced a funding round led by PSG, with participation from Google Ventures, Addition, Samsung Next and Dynamic Loop Capital.
Nym, founded in 2018, sells technology that translates clinical data in patient records into a comprehensive narrative of the patient encounter. The company uses machine learning to automate this process because the manual approach is too costly and time-consuming, pointed out CEO Or Peles.
“[The] manual approach has become increasingly unsustainable over the past several years as the industry faces a persistent shortage of medical coders, ever-changing payer guidelines and razor-thin operating margins. For healthcare providers, these industry challenges are increasing administrative burdens on in-house coders, delaying payment cycles, and leading to compliance concerns that threaten operational and financial performance,” he explained.
Nym’s technology leverages proprietary machine learning models and rules-based clinical ontologies (standardized frameworks for organizing medical terms and concepts) to translate patients’ clinical data into a full summary of their visit. With this narrative in hand, Nym’s engine assigns the appropriate medical codes to the patient encounter, Peles stated.
In Peles’ view, Nym stands out from other autonomous coding solution companies, such as CodaMetrix and Fathom Health, for three main reasons. The first is Nym’s transparency, he said.
“Nym’s engine produces fully traceable audit trails for every successfully-coded patient encounter. These audit trails include supporting documentation associated with each medical code assigned, links to the guidelines referenced by the engine during code selection and more — providing our customers with an actionable resource that they can use in the event of an audit, denial or other compliance initiative,” Peles remarked.
He highlighted Nym’s configurability as another differentiator. Not only is the startup’s technology configured to align with each customer’s internal coding guidelines, but it is also updated as soon as payers or regulators release new guidelines, he said.
Peles also called out Nym’s multispecialty capabilities as an asset. The company’s engine currently supports six specialties and service lines: emergency medicine, radiology, outpatient surgery, outpatient visits, inpatient professional services and urgent care.
The autonomous medical coding technology is compatible with all major EHRs, including Epic, Oracle-Cerner, Athenahealth, Meditech and Allscripts.
Most of Nym’s customers are health systems, large hospitals and physician groups, Peles said. The startup currently has 21 customers, two of which include Geisinger Health System and Ochsner Health.
Photo: Andranik Hakobyan, Getty Images
