Enterprise Computer-Assisted Medical Coding and Core Coding Infrastructure Solution

A health system in Colorado is seeking an enterprise computer-assisted medical coding and core coding infrastructure solution to modernize and streamline medical coding and documentation improvement processes. The requested solution should support inpatient, outpatient, and professional fee coding, integrate with the existing environment, and establish a foundation for autonomous coding with appropriate human oversight and rigorous auditing.

The solution is expected to use natural language processing or similar artificial intelligence capabilities to analyze clinical documentation and support a capture-to-code workflow. This includes ingesting documentation, interpreting records, generating suggested codes, and enabling review, acceptance, rejection, or routing for follow-up. The system should also allow configurable confidence thresholds or business rules to determine when encounters can be coded automatically versus escalated to a human coder, and vendors should explain how machine learning model updates are delivered, including retraining or client-specific tuning.

The scope also includes Clinical Documentation Integrity support, such as case prioritization, auto-suggested assignments, query alerts, collaboration with coding teams, and reporting on CDI intervention impact. Any physician-facing prompts, computer-assisted physician documentation tools, or AI-suggested query content must be compliant, non-leading, logged, configurable, and capable of being disabled if they are not effective. Questions are due by August 5, 2026.