Jan 5, 2023

The Evolution & Future of Medical Billing

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Evolution and future of medical billing

It wasn’t so long ago when medical practitioners coded healthcare claims using thick reference books. Piles of paperwork were stuffed into oversized envelopes, stamped, and mailed to insurance companies. Often the claims never arrived, or when they did, they required hand processing—costing time and money.

Luckily, medical billing and coding procedures have changed drastically. Computers allow medical billers and coders to access information, streamline tasks, and submit claims quickly and efficiently. 

But what does the future hold for medical billing and coding?

Many changes are on the horizon, and the following are some of the most predictable.

Expanding Services Impact the Future of Medical Billing and Coding

Recently, major paradigm shifts have occurred in the provision of medical care. Practitioners have pivoted to technology such as telehealth, artificial intelligence-based intake, smartphones, texting, and mail-order tests to diagnose and provide care. All of these areas will continue to expand and become more integral to medical services.

Increased Need for Medical Billers

Changes can also be seen in how we bill for medical care and even how those services are reimbursed. Services that previously required significant overhead and in-practice support are being streamlined, and the use of remote or third-party medical coding and billing services is growing. And that growth is expected to continue as medical front offices find a new equilibrium, embracing trending services and simple tools to help small medical practices redefine their customer’s needs.

The Bureau of Labor Statistics forecasts that the need for trained medical billing and coding experts will grow by 9% over the next decade. This is partly due to a growing United States population and the fact that Americans are living longer. 

With a strong need for medical billers, technological developments take center stage.

Artificial Intelligence

Artificial intelligence (AI) is beginning to change how medical offices provide care, but more importantly, how billing codes are managed and reimbursed. An increasing number of insurance payers are using artificial intelligence to analyze large medical claims data sets for coding errors, anomalies, reimbursement fraud, and abuse.

Cloud-Based Medical Billing Services

Once a mysterious place filled with millions of data points, the cloud has made its way into mainstream business, but it has also become a reliable tool for the provision of health care. Cloud-based services refer to electronic storage and software maintenance. The cloud allows access to data over the internet while minimizing technology and personnel costs. 

In its infancy, the security of cloud-based medical billing software was questioned by practitioners. But third-party or cloud-based medical coding and billing services are trending. And significant advances in encryption technology have secured the viability of cloud-based medical billing and coding services for use now and in the future. 

Focus on the Patient as a Consumer

The rise of the patient-as-a-consumer concept has introduced a more human element to the practice of medical billing. Medical practices must now consider all aspects of consumer needs and expectations, which requires a more personalized approach than billing procedures used in the past. 

Another aspect of the trend towards patients as consumers is the continued need to protect patient rights and uphold HIPAA privacy laws. Continually evolving, these laws safeguard personal information. And while fundamentally necessary, ongoing requirements add to the demands placed on already busy administrative office staff in both small and large healthcare facilities.

Addressing consumer needs will be a growing trend in the future and is forecast to drive more small medical practices to engage outside services to help fulfill the associated requirements.

Outsourcing Revenue Cycle Management

Outsourcing medical billing, coding, revenue, and communications management are different for every practice and medical specialty. What works well for a family-based practice may need to be adjusted when applied to a surgical team. But overall, revenue cycle management services allow providers to cut costs, maximize billing, and improve care while freeing up time and resources. 

The future of medical coding and billing trends shows that the healthcare industry is growing. As it grows, so does the number of complex regulations and requirements governing practitioners. 

Let’s face it. It is hard to think about the future of your business and profession when most fast-paced medical offices are just trying to get through the day’s workload while still providing quality care.

A recent survey found that over 30% of medical practices, including hospitals, outsource medical billing and coding services. This year the estimated global medical billing outsourcing market surpassed roughly $11 billion. 

And as providers continue to recognize the need for, and benefits of, full-cycle revenue management, this number will continue to grow.

Full Office Electronic Integration

Within the past two decades, electronic claims processing and medical billing have transformed the healthcare industry. With few exceptions, state and federal laws now require providers to utilize electronic records management and claims transmission systems. 

Medical billing software is integral to any practice. Providers run into problems when their software is not integrated with other parts of their healthcare practice. And administrative staff find it difficult when online records still do not align with electronic prescribing laws. In fact, a lack of technological integration can paralyze a medical office or, at the very least, result in costly errors.

In contrast, the time gained by efficiently implementing technology, whether integrated prescription transmission or patient communication, is invaluable.

Revenue cycle management providers are expected to advance the future of medical billing and coding systems by creating seamless software integration as small and large practices demand out-of-the-box integration or comprehensive software packages. 

No one can ever absolutely predict how the future will affect an industry. But considering the trends and using a little common sense is a good starting point. All in all, medical billing and coding or complete revenue cycle management is a service business for a growing profession with a bright future.

Medcare MSO offers state-of-the-art medical billing software along with a full suite of revenue cycle management services. Our customized services allow clients to choose whether they would like assistance with old AR recovery, only billing and claims management, or services ranging from coverage verification to credentialing with payers. If you could use some help with your medical billing or other revenue needs, give us a call at 800-640-6409.

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