Expert organizations like Deloitte projected that between 2015 and 2020, healthcare spending will increase from 2.4% to a whopping 7.5%. Even though the spending is on a steady rise, many healthcare institutions are battling operational costs that are eating into their bottom line.
One of the leading causes of operational costs spiraling out of control is complex medical billing landscape. Each payer uses a different coding system that makes monitoring and recording an extremely complicated affair.
Another reason for increased operational costs is the administrative expenses that account for 25% of healthcare spending.
While medical coding and billing remain an ever-evolving system, one can observe a general shift towards making it more efficient.
Let us take a look at how 2018 will shape billing and coding trends for the coming year-
1. Computer Assisted Coding (CAC)
This refined method of coding utilizes natural language processing to decode clinical documentation recorded in text formats from patient registers. The built-in system recognizes pertinent ICD-10-PCS codes, ICD-10-CM diagnoses, and CPT processes. It also identifies present on admission (POA) signs to recommend codes and relevant documents for CDI experts to examine and approve.
CAC software is being used rampantly these days, especially for recording inpatient claims. Industry analysts predict that computer-assisted coding system has the potential to reach $4.75 billion by 2022.
In fact, the coding experts feel threatened that the efficient CAC integrated with EHRs has the capability of replacing them within a matter of 10 years. However, specialists reveal that this is an exaggerated concern. CAC helps human coders and increases their productivity by 20%.
However, when it comes to eliminating the need for human intervention, this belief is far from the truth. According to a study by Cleveland Clinic, CAC has shown signs of lower accuracy when it is not manned by a certified coder. Experts note that the software may be incredibly useful but is not capable of making standalone decisions or following detailed instructions.
2. EHR Alignment
Reimbursement problems can arise due to improper coding ethics. If the chart data has not been coded accurately or data has been captured incorrectly, it can make it difficult for the coder to locate the record later. A lot of time is wasted by the healthcare providers in looking for right diagnostic codes for their patients, rather than attending to their needs.
With the integration of medical billing software and EHR, especially if your billing system has the provision for CAC, the whole process can become much simpler and faster. For instance, the software can make relevant coding recommendations at the time of being documented. As a result, the codes will be error-free from the start.
By combing EHR and CAC, you can make the system populate patient information automatically into the bill, rather than wasting time into manually entering all the information, introducing a potential for inaccuracy. With the reduction in errors, you can increase your claim acceptance rate and offer a much tighter framework for reporting, rather than depending on the individual software.
The blockchain is gaining acceptance in many industries, including healthcare. It has already been introduced in clinical trials and is favored by many in the medical sector. Experts are already predicting blockchain’s potential in EHRs.
The underlying technology powering crypto-currency has been noted for its ability to improve security and calibration of health data. Some industry experts even go so far as to say that blockchain will bring a paradigm shift in healthcare technology revolution.
Blockchain data storage will be mainly adopted for its improved privacy. At the same time, blockchain enhances the security and efficiency of data exchange. Most importantly, the patients will have greater control over their data.
Rather than wasting precious patient time during the consultation, rummaging for information, blockchain will empower them to give doctors a token that has all the requisite medical information for diagnosis. EHRs reconfigured with blockchain technology makes a lot of progressive sese. Experts also acknowledge blockchain’s ability to transform RCM and claims processing for the better.
Recording all the data, from tests to payments, in an unalterable ledger, blockchain can eliminate potential for fraud. It also introduces efficiency into the system, reducing the time and money spent on locating the information.
2018 is a year for integrations. CAC and EHR will witness seamless amalgamation for improve medical billing and coding services. At the same time, blockchain will make inroads in the healthcare industry, further strengthening the coding and billing system.