Artificial intelligence and machine learning are the latest trends in healthcare IT. The two disciplines have reshaped technology and opened new paths for the future. So, how could medical billing and coding services refuse to accept this vital shift? The healthcare system overall is working on modern technologies to achieve its higher goals. These goals may include the delivery and accessibility of patient care to everyone, everywhere.
In this blog, we will overview the
potential impact of AI and ML on medical billing services. And how medical
billing and outsourcing companies are adapting themselves to the new wave of IT
advancements.
Artificial Intelligence (AI) and Machine Learning (ML) in Healthcare
People across the world have shown
special interest in the latest technologies. But in the past few years, the
idea of AI and ML has spread like wildfire. Everyone is talking about the use
of artificial intelligence in the industry to ease tasks. So, the same is the
case for healthcare professionals and medical billing and coding services.
However, this general idea about AI in medical billing and healthcare garners
attention and prompts a single response: "How may technology displace
doctors?"
Well, this is some sort of exaggeration.
This technology will improve healthcare. And all in all, it will help
professionals do their jobs conveniently.
The Hype for using AI in Medical
Billing and Coding
Let’s get back to the lesson that a
worldwide epidemic has taught us!
Looking back in history, we can see that
the healthcare system has many flaws. Also, you must notice that many issues
start with how we do fundamental administrative chores like paperwork and
coding.
Who was handling the internal and
external administrative and clinical tasks at that time? Humans like us. Is
making mistakes in medical claims their hobby? The answer is no.
There are multiple reasons behind the
errors in healthcare. One of them is the burden of administrative chores. Not
only in COVID days but also prior to the epidemic, this was the primary cause.
There was almost 42% physician burnout at that time.
Despite those alarming figures, the
healthcare business is currently going through an extremely exciting period.
The processing power of the healthcare industry is catching up to the growing
amount of data right now. Thereby, we can see an increase in medical billing
and coding companies in the USA. All old and new medical billing outsourcing
companies have employed the latest technologies. This will not only help them
save the money they were previously spending on hiring more employees. So, this
marks an increase in the use of technology that will lighten the administrative
load. Eventually, it will free up clinicians and clinical staff to focus once
again on the main reason they entered the medical field: treating and caring
for patients.
AI: A Hope for a Bright Future of Medical Billing and Coding
Consider some statistics about medical
billing services.
●
The annual error rate in
medical bills is around 30%.
●
In billing, almost 80%
of medical claims are erroneous.
Although we have successfully overcome
the COVID crisis, we must take these numbers seriously. If we do not act on
reducing this exponentially increasing error rate in medical claims, it may
make or break a company in the future.
To combat all these conditions, we must
leverage AI and ML in our healthcare billing services. However, this all begins
with how machine learning will affect medical coding. And how it will allow
physicians to spend more time with patients and less time on their computers.
Augmentation in the Coding
Medical billing is a sort of work that
requires human ability and skill in assigning the right codes. However, we can
pair human abilities with the latest technology to augment the billing
profession. This combination can give superpowers and efficiency to healthcare
in dealing with erroneous billing issues. AI-based technologies/programs mainly
mimic human operations and are thus able to perform tasks. Also, they can give
code suggestions using the data we enter into the EHR system.
Autonomous Coding Operation
The ultimate AI implementation in medical
billing and coding is to induce automation in coding as well. Just like
different billing software can perform several command-based tasks on their
own, we want the same for complex coding. However, our AI-based coding system
must be efficient enough to handle it, as coding is a complex process. Once AI
systems are established, the human role will be quite prominent. Do you know
how?
Well, as we have stated earlier, AI
programs can mimic human operations. Later, they can use the stored information
to make critical decisions. So, without learning from human providers and
coders throughout the augmentation phase, autonomous coding is not possible. It
won't have the effectiveness we require from the technology.
Medical Billing Audits
External and internal audits are
necessary for the efficiency of medical billing and coding systems. However,
owing to resource limitations (such as people and money), it is just not
possible to do it more frequently. However, with AI, there is a chance to see
the ROI and cost-benefit shift in favor of universal accessibility across both
provider and payer organizations as we upgrade current technologies.
Conclusion
Our current medical billing and coding
system is so complicated. It increases the administrative load on doctors and
other healthcare professionals, adding 16 minutes per patient on average.
However, we can see the fork in the road that leads to a far more sustainable
and "super-powered" future. Here, automated computers will handle the
labor-intensive job so that professionals can focus on what we need them to
accomplish and what they want to do.
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