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The Impact of Technology on Medical Billing and Coding

Medical billing and coding, outsourcing billing companies, medical billing and coding services, medical billing outsourcing companies, healthcare professionals, healthcare industry, healthcare services

Medical billing and coding have undergone various changes. At first, the payment transaction methods were not clear. Then from the late eighties to until a decade ago, billers and coders had to write down every single detail manually on papers. The information collected was cipher into the designated codes or electronic codes to be stored in the hospital’s database.


You can assume that the process of getting claims was surely not a cup of tea. It was lengthy, and most of the time, human errors were a big problem in creating clean claims.

Since technology has been a great invention and is making waves in the medical billing industry like other fields. Now professional outsourcing billing companies relay on encoders to mitigate human errors and to increase the precision of the claims. The process is more streamlined than ever and aligned with the companies’ objectives. But relying simply on encoders can also seriously damage your claim processing.

Why Professional Medical Coders are Crucial for the Healthcare Industry despite Encoders?

Medical billing and coding, outsourcing billing companies, medical billing and coding services, healthcare professionals, healthcare industry,

Yes! Encoders make life easy, and medical practitioners who opt in-house billing and coding teams become easily sufficient using these tools. However, the importance of well-trained coders defines a systematic way of compiling claims. Their expertise helps in official documentation and using correct terminologies and side notes for optimized performance.

However, a well-aligned combination of technology and medical coders offers a reliable, cohesive, and accurate working environment. No one can deny the importance of medical coders, however, digitalization is meant to take over.

Five years back in 2015, ICD-10-CM codes were implemented and made compulsory to adapt by every medical practice. This practice demanded investments of about $56,639 to $226,105. However, this change was inevitable, as many cases were reported to insurance companies via wrong coding updates or practices.

Although, CMS (The Center for Medicare and Medicaid Services) releases updates to accommodate changes and for the raised concerns, they are addressed from time to time.

Researches are conducted on a larger scale and let’s be fair, the updates might not be enough to accommodate all technology and policy changes. For Instance, coders say that changes in the codes are not easily available or adopted by the professionals and effects on the claims and documentation. So, what is the solution? In such cases, technology serves as the saving grace and cloud-based systems ensure that code database remains updates 24/7.

The Use of AI (Artificial Intelligence) in Medical Billing & Coding

Medical billing and coding, outsourcing billing companies, medical billing and coding services, medical billing outsourcing companies, healthcare industry, billing services

The US Bureau of Labor Statistics estimates that between the years 2014 to 2024, medical coders will increase up to fifteen percent only in the U.S. But, can we predict that technology might restrict his growth?

We believe it will not be the case.  For Example,

Cliff Notes – A document generated by the system after the processing of the medical record of the patient. This document has issues that are resolved by the medical coder. Apart from this, many other errors need revision and rectification from the coders and billers. Looking into statistics, up to ninety percent of the claims contain errors of some kind, and it led to leave up to $750 billion each year. That’s why you cannot challenge the position of human monitoring in the billing process.

Having said that, many medical practices and hospitals are deploying hi-tech programs, machine learning, and artificially intelligent computer-assisted coding systems (CAC). These systems not only process claims but also, identify mistakes and give feedback for the coder’s assistance.

Such machines make us think that the future of manual help in medical billing and coding services is going to be extinct, but healthcare leaders believe technology should not be let dominated completely but only allowed to be a part of the healthcare industry.

Technology Incorporation is a Measure of Cost Reduction in Healthcare

healthcare professionals, outsourcing medical billing company, billers and coders, outsourcing billing companies, Medicare and Medicaid Services, healthcare system

America has one of the most expensive healthcare systems in the world. Almost one-third expenses of this system are spent to cater to the administrative load. Technology, thus, cannot replace human existence from the core, but it can be used substantially to reduce increasing cost expenses.

For Instance,

Technology can be used to overcome charges for duplicated claims, upcoding, and other errors. This push to reduce expenses via technology is moved forward by the payers.

Where to Go From Here?

It is observed that medical billing companies and healthcare professionals are more concerned about the administrative load, such as transportation instead of technology incorporation. Indeed, investment in technology at once is a bit expensive, but it reduces the burn-out option of the resources and systems. The changes are more on the back-end for the billing services and physicians rather than the patients.

Technology, as in artificial intelligence and machine learning also helps in diagnosis and documentation of treatments, affecting the cost to be reduced.

Thus, the future we see is a progressive healthcare system, where technology and human work simultaneously and in perfect harmony to avoid mistakes.

Many experienced and well-renowned medical billing outsourcing companies, who have their worth in the market as a company that is up for simplifying solutions, are already using technology. Just like here at P3Care, we believe when there is good coming up, why not use it for the benefit of physicians.

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