The billing and revenue cycle management process for healthcare providers involves several complicated steps. It includes scheduling visits, enrolling, verifying insurance, submitting claims, following claims, and collecting payments.
That is why most healthcare providers are switching to innovative solutions for their medical billing and revenue cycle management practices. These are some of the latest trends adopted by the medical industry in 2021.
Automated Medical Billing
In the current age, health care organizations rely on cloud-based software to handle medical billing. The software can streamline all the billing activities efficiently, including claim submissions, insurance management, bill generation, and payment records.
Automated billing software also reduces the chances of errors in filing and processing insurance claims because it flags potential mistakes well in advance. Therefore, many executives can solve the problems proactively, thus minimizing any delays or denials in payments.
Healthcare professionals can access cloud-based medical billing systems from anywhere, which is one of the reasons that makes them so popular. Many of these cloud-based solutions also provide a selection of free invoice templates for Word or Excel for additional convenience in billing.
However, medical billers should keep in mind that the technology is not 100% error-proof and, therefore, they should be proficient while using these tools.
Reduced Data Mining
Healthcare technology companies were quite focused on obtaining big data not so long ago. However, most of the burden to derive sustainable business intelligence from the collected data fell on the shoulders of healthcare organizations.
Thankfully in 2021, the industry has moved on to the latest analytical technologies that use AI to derive results from the collected data. It allows them to retrieve actionable insights using their computers or smartphones.
Using analytics-based tools can tell a medical organization how their operations fare compared to the other healthcare facilities regarding financial key performance indicators (KPIs).
Some vendors realized that physicians or medical executives lack the time to go through endless reports to point out the necessary changes to the current financial operations or judge whether the adjustments are achieving the desired results are not.
That is why some practitioners and executives act as consultants now and offer a hands-on approach to use technology to derive analytical results. They also test those insights to examine the impact on the financial procedures of an organization.
Medical organizations can now use blockchain technology as a secure way to create authentic data records and share them with database systems connected to their network.
The digital events get recorded in a way so that the data cannot be read or manipulated until it reaches the recipient. Blockchain technology is crucial to protect confidential patient information managed by healthcare centers, such as:
- Health information for patients
- Electronic health records(EHR)
- Data collected by Internet of Things (IoT) technology
- Data monitoring systems
- Medical billing sentience
According to market Insight reports, there are predictions that the Computer-Assisted Coding (CAC) industry will have a compound annual growth rate (CAGR) of 11.3% between 2020 and 2027. CAC enables the automatic generation of medical records from clinical documents.
The system also uses natural language processing (NLP) to determine the crucial International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) coding terms and expressions on those documents.
Medical coders can use CAC to boost their accuracy and productivity. Healthcare organizations also benefit from CAC to improve their legal compliance and streamline medical billing.
Even though ICD 11 will come into effect on January 1, 2022, medical billing companies and individuals should start familiarizing themselves with the codes and their implementation in clinical documentation in the coming year.
ICD 11 will add many new chapters with almost 55,000 codes for various kinds of ailments, injuries, and factors causing death. It is going to be an entirely electronic system that has been designed to offer support to EHRs.
It will also have a new content model including 13 parameters to prevent duplication or confusion regarding medical codes in billing. ICD 11 will also offer better ways to understand a medical bill for patients, insurance company personnel, and other non-medical professionals.
Virtual Medical Care
The COVID-19 pandemic has made virtual medical care a reality. It combines digital communication technology with medical care to bridge the gaps between patients and medical professionals. Healthcare providers can use these technologies to provide better and efficient services to patients.
Virtual healthcare offers higher returns on investments as the medical care sector transitions from the fee-based model to value-based compensation. However, medical billing for virtual patients would be quite different from the bills of those getting treated in person.
The rules and regulations for billing virtual medical care might vary between government and private healthcare providers. Therefore medical billers must know the applicable codes according to the telemedicine guidelines to ensure appropriate reimbursement. They may also need to find out if a patient’s insurance covers virtual healthcare.
We have noticed patients evolving a lot in 2020 as healthcare consumers. We believe these innovative trends are going to transform the landscape of medical billing and revenue management practices for the entire healthcare industry.