Top Trends in Medical Billing

Medical billing has been an essential part of reimbursement in healthcare for decades. The professionals in this industry, though, used to either draft necessary documents by hand or use a typewriter. Not only was this manual process extremely time-consuming, it led to inaccuracies and other medical errors.

Technology has certainly transformed the medical billing industry and continues to do so through automation, the application of artificial intelligence (AI) and machine learning and the integration of electronic health records (EHR) systems. Also, a large number of healthcare providers are investing in outsourced medical billing because it enables them to focus more on their number one priority: patient care. In fact, the market for medical billing outsourcing is projected to reach $23.1 billion by 2027.

Automation for Increased Accuracy

The emergence of automation in healthcare has markedly streamlined clinician workflow and positively addressed the problem of physician burnout. It also boosts productivity and efficiency for various professionals employed by hospitals, health systems and physician practices through processes such as online scheduling, automated appointment reminders and patient check-in and more.

An increasing number of providers are employing automation to handle administrative tasks and increase data accuracy. In addition to time savings, automated medical billing decreases delays and denials in reimbursement, offers more comprehensive reporting, provides more thorough documentation and allows staff to accomplish more work in less time.

Artificial Intelligence for Improved Productivity

AI and machine learning are being adopted by a multitude of industries, healthcare included. These algorithm-based technologies improve accuracy and automate many time-consuming tasks, allowing employees to focus on other operational tasks. They also integrate into billing workflows to prioritize the work queue for resubmitting denied claims, which helps to cut costs and increase patient satisfaction, and can be utilized to verify and correct patient demographic information, customize billing statement releases. Detractors of implementing AI and machine learning in medical billing point to possible job loss for coders, but the technology is designed to enhance their capabilities.

Much of the use of AI and machine learning in medical billing is centered around computer-assisted coding (CAC), which one study found helped increase coder productivity by more than 20% and lowered coding time by 22% compared to those who didn’t utilize it. According to reports, the global market for CAC software is expected to reach $4.75 billion by 2022.

EHR Integration for Robust Reporting

Integrating EHR software with medical billing systems isn’t a new trend, but it’s one that’s expanding, especially as almost 86 percent of office-based physicians use an EHR system. A key reason for this increase is improved interoperability.

Advantages of integrating medical billing systems and EHR software are many, from in-depth reporting capabilities to the ability to perform digital payment processing via patient portals. Additional benefits include improved efficiency by removing the need to fax or photocopy every billing sheet; enhanced comprehensiveness by being able to access data from a single location; decreased coding errors through cleaner claims; and reduced paperwork due to the elimination of manually filling out forms.

Outsourced Medical Billing for Better Payment Rates

Outsourcing medical billing enables providers to allocate more employee resources to other aspects of their business, achieve better payment rates and faster cash flow and increase compliance with healthcare regulations. As we discussed in a previous blog, it also offers better savings, profits, control, industry insight and consistency. Those are only a few of the reasons the outsourcing medical billing market continues to steadily grow.

In-house medical billing means practice staff is responsible for all aspects of revenue cycle management and must submit claims for reimbursement, set charges, collect patient fees and manage the accounts receivable. Through outsourced medical billing, a medical billing service conducts those functions, usually in return for payment through a percentage of a practice’s collections.

Find out how outsourcing patient demographic entry and eligibility gives you the opportunity to increase your collections through a systematic follow-up method and identify core reasons for your unpaid claims.