Due to the COVID pandemic, hospitals had to operate on tight margins and extract the maximum out of the revenue cycle more than ever. The pandemic highlighted the importance of medical billing services all the more as it had become a struggle to keep up with the testing and immunization records. The post-COVID healthcare industry will be much more complex than earlier. In the coming year of 2022, this will result in the introduction of key technologies and process innovations to improve business outcomes.
There have been a few recent changes that have impacted the medical coding and billing industry significantly. Let’s understand these changes and how they might affect 2022.
Adding COVID-19 Codes
The sudden pandemic and its effects forced the healthcare industry to make some changes in their system, to cope up with the situation. A few codes had to be added for streamlining and tracking the procedures, medical tests for COVID detection, treatment, and immunization related to it. These changes will be an important part of the medical billing system, specifically in 2022.
Transitioning to New ICD Systems
The medical billing industry has already made a major shift to ICD-10 from ICD-9. It is a global system used to classify and code symptoms, diseases, and medical procedures. Though ICD-10 was implemented as early as 1999 for reporting mortality, it was very recently implemented by medical providers and insurance companies. The new system made way to more than 140,000 new diagnostic codes and procedures.
The World Health Organisation (WHO) has already approved the usage of ICD-11 from January 2022. Hence, the new system will come with more changes; for which all professionals need to be trained to keep up with the new codes, rules, etc. This will also shed light on the importance of continual training that goes beyond certification credits or continuing education units (CEUs).
Replacing Medicare Physician Fee Schedule
This recent major change enacted by the Centers for Medicare and Medicaid Services (CMS) in 2021, is one of the first implemented in more than 10 years. Hence, reimbursem*nts and fee schedules in the future will be changing. This will also require professionals to get additional training to keep following the new changes.
Increased Automation
Automation has proved to be a boon in the healthcare industry by helping to reduce physician burnout, increasing accuracy, and streamlining workflow. It has efficiently boosted productivity for various professionals through processes like automated appointment reminders, online scheduling, or patient check-ins. Not only for saving time, but automation has also helped in reducing delays and denials during reimbursem*nts.
The next year and the future look promising on this front. Increased automation can provide for more thorough documentation and completion of tasks in less time.
Increase in Use of Artificial Intelligence
With the other industries, healthcare has also adopted AI and machine learning as its part. It has helped to cut costs and increase patient satisfaction by integrating billing workflows and creating work queues for claim re-submissions. It has also been used to correct and verify the demographic information of patients and customize billing statement releases.
It’s a myth that AI being a part of Computer-Assisted coding (CAC) will reduce human jobs, but it has been proven that the software has been less accurate without the help of a professional human coder. The technology is perfectly designed to enhance the capabilities and increase the productivity of medical billing professionals.
Aligning EHR Software
Almost 86% of office-based physicians already use the EHR software and it has many proven advantages. This feature never stops expanding and surely won’t in the coming year too. It ensures robust reporting and helps perform digital payment processing via patient portals. It also helps in reducing the need to photocopy each billing sheet, using cleaner claims to reduce coding errors, accessing data from a single location, and keeping manually filling forms at the minimum.
Changes in Medical Billing Industry Statistics and Outlook
- According to the Bureau of Labour Statistics, employment in the field of medical billing is expected to grow by 8% on a national level in 10 years, from 2019 to 2029.
- Family healthcare insurance plans have moved to a higher-deductible model and consumers will be able to use their Health Savings Accounts (HSAs) for covering the costs.
- Patients have become more aware of their payment responsibilities and generally want to know their bills upfront considering the growth of electronic payments. Unfortunately, traditional medical billing may delay the collection process by as much as 30 days. The industry is coming up with new payment models such as Revenue Cycle Management (RCM) which can help manage patient payments easily and streamline the whole process.
Some other upcoming changes in 2022:
- CMS has come up with a few provisions related to the Affordable Care Act (ACA) coming into effect in 2022. It will help in better medical access for U.S. residents.
- The European Commission has proposed an AI-based framework for Europe, which might be the first legal framework and might come into effect in 2022.
- The No Surprise Act coming in 2022 for Americans will make health providers treat out-of-network services as in-network services, except ground ambulance transportation.
Even if it is the most crucial part, selecting the proper code and accuracy continues to be challenging in this constantly evolving field. It is integral for efficient working of bill payments and preventing fraud at the same time. Educating all the professionals periodically about billing system changes, insurance regulations, Medicare policies, and medical privacy laws.
Outsourcing Medical Billing Services to the Rescue!
Outsourcing medical billing to another company helps providers focus more on patients, increase productivity, and reduce burnouts. It enables providers to allocate their resources in other aspects of their business. Plus, these companies who take up the outsourced work are compliant with the current healthcare regulations and strive to ensure steady growth. Outsourcing help businesses lessen their burden as they take care of all aspects of revenue cycle management, manage the accounts receivable, and timely submission of claims for reimbursem*nts.
Consider choosing 24/7 Medical Billing Services for all your needs. Simplification of your billing, dedicating resources to payer reimbursem*nts, and ensuring the accuracy of claims; everything will be taken care of!
Read more: How To Find The Right Medical Billing Outsourcing Company?
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- EHR software
