AI agent for tutors
Coder Education Feedback Agent
Each coder's recurring error patterns drop measurably within one month
What it does
Coding educators get audit results and denial reports, but turning them into targeted training for each coder takes days. This agent groups recent audit findings and coding-related denials by coder and by error type, such as wrong modifier, missed laterality or wrong principal diagnosis. For each pattern above a threshold, it drafts a short education note with the guideline reference and two examples from the coder's own work. The educator reviews and sends. Thirty days later the agent samples that coder's new charts for the same error type. If the rate has not dropped, it flags the pattern for a one-to-one session. It never ranks coders publicly or feeds performance reviews without the manager. Edge case: when an error traces back to a wrong payer rule in the system, it sends the item to the charge master team instead of a coder.
How it works
Follow the arrows from top to bottom. The orange dashed arrow is the loop: when a check fails, the agent goes back and tries again.
Read the steps as a list
- Monthly audit results posted
- Collect audit findings and coding denials by coder
- Group errors by type and count per coder
- Is the error caused by the coder rather than a system rule?If not: send the item to the charge master team and regroup the rest. Back to step 3.
- Draft an education note with guideline reference and two own examples
- Educator reviews and sends the noteThe agent waits here for your OK.
- After 30 days, sample new charts for the same error type
- Has the error rate dropped below the threshold?If not: flag for a one-to-one session and draft a revised note. Back to step 5.
- Education log with before and after rates
How it decides
A pattern needs education when the same error type appears at least three times or above 5% of a coder's audited charts; system-rule errors are routed away from coders.
- Three or more of the same error, or over 5%, triggers education
- Errors traced to a payer rule in the system go to the charge master team
- Follow-up sample is 20 charts or all charts if fewer
- Two failed follow-ups escalate to the manager
Make it yours
Every agent is a starting point. You choose these settings for your own situation.
- Error threshold for education (default 3 errors or 5%)
- Follow-up interval (default 30 days)
- Sample size for follow-up (default 20 charts)
- Error types in scope
What keeps you in control
It always asks you first
- Educator approves every note before it reaches a coder
- Manager approves any escalation
Hard limits
- Never shares individual results with peers
- Never feeds performance ratings without manager action
- Uses de-identified examples in group training
It stops when
- Done: every pattern educated and followed up
- Stop: fewer than 10 audited charts for a coder this month
Set it up
We guide you through the set-up, step by step
Members get the full set-up guide for this agent. No technical skills needed: you copy, paste and upload.
- One set of instructions to paste into your AI, with the clicks for ChatGPT, Claude, Microsoft 365 Copilot, Gemini and Grok
- The agent then walks you through connecting your own data, one source at a time
- A downloadable copy with the flow chart, the rules and the full guide
