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5 Trends in Medical Billing Expected to Remain Strong Through 2020

The medical billing field is changing and evolving rapidly. Every year brings new technology, and new regulations come into play—but within all that change, there are some strong trends that give us a clear picture of the direction things are moving in, so we can plan accordingly. Here are six trends we expect to remain strong.

  1. Claims Processing Becoming Increasingly Electronic

Medical coding and billing depend so much on electronic resources, it is difficult to believe that until very recently, all medical billing was done on paper. Coding software has become a necessity for keeping up with all the latest revisions to the codes. Not only do codes change, but payers make changes to claim requirements, and errors in claims result in rejections, which in turn result in a lower percentage of claims being paid. It has become impossible to keep staff sufficiently trained to incorporate all the modifications, and since the best software packages are continually being updated, electronic filing is much more efficient.

Filing claims electronically also allows for bulk processing resulting in faster payments.

  1. Artificial Intelligence (AI) Being Developed to Streamline the Process

When denied and rejected claims are reviewed one at a time, the process is not only time-consuming, but it is difficult for common errors or problems with payers to be recognized. AI can run advanced analytics as claims are electronically processed and quickly identify where the problems are.

Knowing, for example, that a particular payer is repeatedly denying payment for a procedure on the basis of medical necessity allows the provider to take action to resolve the disagreement, rather than appealing claim after claim. AI learns continually, and accumulated knowledge is not lost with changes in personnel, so it becomes continually more valuable over time.

  1. Medical Billing Software Increasingly Accessed Via Internet

“The cloud” is the general term for offsite electronic storage and data access via the internet. Having medical billing software in the cloud rather than on each computer in the office results in less risk from hardware failure, faster software updates, and facilitates the use of tablets. There are many potential points of failure in the chain of actions necessary for updating software on office hardware that are eliminated by having the update done at a single point in the cloud.

Initial reservations about data security and protecting patients’ private information have been put to rest by data encryption technology and other developments that make cloud-based software extremely secure. In fact, the best medical billing companies partner with the same data security companies that banks use.

  1. Increasing EHR Interoperability

Electronic health records (EHR) have resulted in patient information being kept in a much more usable form with the intention of giving physicians the ability to access the patient’s full history and to communicate with each other when concurrent or collaborative treatment is necessary. The challenge now is developing interoperability of the various EHR systems, so that the connection and communication are seamless. This is actively being addressed an is a major focus for developers.

Interoperability of EHR and medical billing software is another area of development to streamline processes within each practice and support billing communication and electronic payments being collected through patient portals.

  1. Outsourcing Medical Billing to Professional Billing Companies

The number of health care facilities that hire a professional billing company for revenue cycle management (RCM) continues to increase and that trend is expected to remain strong. It has become very challenging to keep medical office staff up to date on all the changes being made both by regulations and insurers plus paying for software updates. Every time there is a personnel change in the billing staff of a small practice, the result is likely to be delayed claim submissions and a resultant lag in payments received. By outsourcing medical billing, these delays are avoided, current software is made accessible and physicians are allowed to give more attention to patients.

Medcare MSO is a dedicated RCM services provider. For nearly a decade, we have been taking care of all aspects of medical billing for our clients who report increased income, well in excess of the cost of the service. Give us a call today at 800-640-6409 to find out how you can increase your revenue and be free of the stress of medical billing.

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