The significance of the healthcare system has been raised since the proliferation of the COVID-19 pandemic. It has put so much stress on the healthcare providers. Medical coding, billing, and documentation assist in guaranteeing that healthcare providers can provide on-time payments for their clinical and medical services.
Introduction
Medical billing and coding are two different positions that need some degree of training because of their specialization. Both professions present the same opportunities for people to find both in-person and remote positions. There are employment opportunities with medical documentation companies, insurance companies, and healthcare providers. Another option is for medical billers and coders to function freelance. They can function on contracts with medical agencies and facilities. Of course, AI benefits both billers and coders as it can assist in automating some characteristics of the job that are either too difficult or weaken the possibility of the employee in question. There has been a latest threat regarding people losing their jobs due to the popularity of AI. Human judgment will always be preferred over that of a machine.
What is the Difference Between Medical Coding and Medical Billing?
Typically, medical coders are the first people to see a patient’s medical record. This commonly begins as early as the patient sees their healthcare doctor (ex. Nurse practitioner, clinical psychologist, procedure, optometrist, dentist, podiatrist, and doctor). The healthcare provider specifies items, processes, and services utilized during the patient’s stay in the healthcare facility. This highlights the ever-increasing significance of medical billing services.
By law, providers need clinical documentation to provide treatment. This is a sign if an investigation follows because of conflicts in the claim. The patient’s medical record goes to the medical coders after the provider discharges the patient. The provider then analyzes and reviews it to develop a connection to billing codes relevant to a process or diagnosis.
The medical biller takes over, and the medical biller is done determining the billing code. Then, the medical biller records all the insurance claims. These claims transform the billing code into a formal bill. This guarantees that the medical data is precise. Healthcare insurance companies then attain this bill. They settle the plan denials, details, and rejections. Then these statements are dispatched to the patients.
AI in Medical Billing, Coding, and Documentation
Like many other professions, Artificial Intelligence (AI) has taken over medical coding and medical billing. This profession pinpoints and takes out data from medical documentation and medical records. It also implements suitable codes. However, this software is not planned to take away jobs from the medical billers and medical coders. The US Bureau of Labor Statistics thinks that the quantity of medical coding jobs will rise by 8% between 2019 and 2029. This software aims to save high-cost mistakes like inaccurate billing because of inaccurate coding. For this reason, organizations look for medical documentation service providers.
The healthcare revenue cycle also discloses the requirement for this Artificial Intelligence (AI). Characteristically, audits occur very late in the revenue cycle which limits their usefulness. For instance, the patients are already paying timely bills; however, the audit has occurred and identified inaccuracies. This shows that the audit must take place quickly and frequently.
The AI software eliminates the workload of medical coders. This allows them to concentrate on more meaningful work or the tasks that AI has not been able to help with like identifying trends and reporting the diagnoses.
Conclusion
Medical coding and billing is a growing industry and it is very high in demand. Both insurance companies and medical providers see these positions as important, and there is no labor scarcity due to the ever-growing population.
Frequently Asked Questions (FAQs)
What is meant by medical documentation?
Documentation normally addresses the reason for the patient’s visit, the assessment or treatment provided, clinical findings (including diagnoses), and, if any, the treatment that was recommended/provided in a manner fulfilling justification for the applied diagnosis/procedure codes (see Coding for Reimbursement).
What are the 7 fundamental categories found in a medical record?
Identification Information, Medical History, Medication Information, Consent Forms, Lab Results, Medical Directives, Treatment History, and Family History.