New: independent coding checks for insurers and providers. See how Lens works →

MEDIKODI Lens

Feedback on any coded case, or thousands

Lens is an independent quality check for clinically coded data. Upload one episode or a full extract and see what the record supports, what it doesn't, and what's worth a second look.

One standard for coded data, whoever did the coding.

Lens holds every episode to the same indicators and rules, whether a hospital, a health fund or an auditor is checking. A finding means the same thing to all of them.

How it works

Know which episodes to review, and why

Lens runs coding quality indicators across everything you upload. Where one is triggered, you see the code, what the record shows and the rule that applies.

What the indicators check

Accuracy

  • Codes the record doesn't support
  • Conditions and procedures documented but not coded
  • Principal diagnosis and sequencing

Specificity

  • Unspecified codes where the record is specific
  • Combination and complication codes
  • Where better documentation would add detail

Grouping

  • Whether the DRG matches what the record supports
  • Complexity checked against the documentation
  • Ungroupable and error DRGs

Standards

  • Coding standards, conventions and rules
  • The current classification edition
  • Your organisation's own rules

Across the whole set

See where quality slips, and start there

Compare hospitals, sites or coders against the group average, and see which issues keep coming up.

Useful on both sides of the claim

  • For insurers and health funds

    Check the coding behind the claims you pay

    Where an agreement pays by DRG, the codes decide the benefit. Lens shows whether they hold up, before or after payment.

    • One claim, one hospital or a whole period at a time
    • Unsupported codes and uncoded care, reported separately
    • Evidence ready for the hospital's right of response
    • Only the episode being claimed, not a patient's history
    Lens for insurers
  • For hospitals and health centers

    Know your coding quality before your funders do

    Health funds, state agencies and auditors all review your coded data. Lens lets you see it the way they will, before they do.

    • Documented care that wasn't coded
    • Quality measures you can report on
    • Themes for coder education and documentation
    • Preparation for health fund contract audits
    Lens for hospitals

Simple to start, safe to run

  • Nothing to install

    Lens runs in the browser, with no integration project. Only what you upload is assessed.

  • De-identified before assessment

    Sensitive details are reduced before processing, and hosting is agreed with your IT and security teams.

  • Kept current

    Indicators are updated when the classification or the coding standards change, so results stay comparable.

Questions & answers

What insurers, coding managers and quality leads ask about Lens.

What can we upload?

A single episode with its clinical documentation, or a coded extract of many episodes. With the record, Lens checks each code against the documentation. With coded data alone, it checks the coding against the classification, the standards and the grouping.

How is Lens different from audit in MEDIKODI Coding?

Audit in MEDIKODI Coding is part of a hospital's own workflow: reviewers check and change codes before an episode is final. Lens is separate and independent. It assesses coding done anywhere, by anyone, and is used by insurers as well as providers.

Does Lens only look for over-coding?

No. It also finds conditions and procedures the record supports that weren't coded, so reviews stay balanced.

Do you check every episode or a sample?

Every episode you give it. Instead of hoping a random sample is representative, you choose which findings to review.

Do you work for hospitals or for insurers?

Both, on the same terms, and each customer's data is kept separate.

Does Lens replace a clinical coding audit?

No. Lens points reviewers to the episodes worth a closer look. A qualified coder or auditor confirms each finding against the full record, and your organisation decides what to act on.

Is Lens available now?

Lens is in a pilot with a small group of insurers and providers. Join the pilot to try it on your own data.

Start with a sample of your own

Send us a recent extract. We'll run Lens on it and walk you through every finding.