Medical Billing was always a challenge, whether your medical group had its own staff or outsourced it. While software has been working towards making the entire coding and billing process easier, it still has room for improvement. 2021 will see a lot of advancements not just in technology, but in the processes as well
Let’s have a look at the top 5 trends that will rule 2021.
1. Automation and Artificial Intelligence (AI)
Hospitals and clinics spend significant effort on preparing, submitting, following up, and appealing medical bills. The expenses on medical coding and billing and insurance activities can be a massive 3-25% of the total bill, depending on the type of service and facility.
Medical clinics have been using EHR systems, practice management systems, and billing software for quite some time now. But vendors are now making efforts to integrate these systems with the help of AI and NLP.
Picture this: you examine a patient and talk to her. Your voice-enabled, AI-powered EHR system automatically extracts the important parts of the clinical encounter and enters the data into appropriate places. Then your practice management software automatically takes that information and generates CPT and ICD-10 codes. And then the billing software uses these codes to submits a complete, error-free claim. All this will happen without you having to enter data from one software to another, as all these systems will be integrated into one.
As the use of AI will increase in the medical billing process, fewer staff members will be required, and more claims will be realized on first pass. Furthermore, reimbursements will become quicker, and your revenue cycle management will be immensely improved.
2. More Outsourcing of Medical Billing
Billing and coding need more and more precision day by day. However, maintaining that level of expertise and diligence is difficult in-house. This often causes errors and delays which are deleterious to reimbursements.
ICD-10, with 14,000 diagnoses and five-digit codes, are difficult for clinic staff to manage. Hence, errors, under-coding and underpayment, and rejected codes are bound to happen.
That’s why, 2021 will see more and more practices partnering with billing specialists and companies. These firms have staff dedicated to preparing and submitting accurate and clean claims. Using them frees up clinic staff for patient care and is better for the revenue cycle maintenance.
3. Electronic Claim Submissions
Quick and accurate claims, and immediate proof of submission – what is not to like?
Electronic claims will become the norm as we move forward. Paper submissions are still required by some payers, but their numbers will keep on shrinking in coming years.
4. Higher Co-pay Proportion from Patients
More and more people now have high-deductible and copays policies. Because some employers only offer these policies. According to the US Bureau of Labor Statistics, 45% of employees had such plans in 2018.
30% of the average healthcare bill now comes from the patient’s pocket. Therefore, collecting directly from patients without alienating them will be a vital aspect of revenue cycle management in healthcare in 2021.
Top 5 Medical Billing trends: 2021
However right now, it costs four times as much to collect from a patient as from an insurance company. Therefore, practices will need to adopt some measures to speed up direct collections:
5. Technology Improvements in Medical Billing Process
Medical coding and billing efficiencies will expand in 2021. The best medical billing systems will use software-generated, precise CPT and ICD-10 codes to maximize reimbursements and eliminate errors.
Experts handle rejected and denied bills using AI and machine learning for quick turnarounds. Moreover, systems print patient addresses on medical bills that match names against large address databases, preventing bills from being sent to old addresses. In this year, these technologies will be further improved resulting in more accuracy and efficiency.
Medical billing is both the lifeblood and the bane of medical practices. Healthcare payments are often opaque, unpredictable, and difficult to manage for both patients and providers. In fact, more patients change their providers because of billing disputes rather than for the quality of care. While large hospitals can afford the expenses of specialized billing staff; for independent practitioners, the services of billing partners are invaluable.
We hope these 5 trends will help your practice be better prepared for 2021.
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