The Evolution & Future of Medical Billing | XyberMed

It wasn't that long ago that medical professionals coded their claims for health care services using thick reference books. Stacks of paperwork were stuffed into oversized envelopes, stamped, and mailed to insurance companies. Often the claims never arrived, or if they did, they had to be processed by hand, costing time and money.

Fortunately, medical billing and coding procedures have changed dramatically. With the help of computers, medical billers, and coders can access information, streamline tasks and submit claims quickly and efficiently. 

But what does the future hold for medical billing and coding?

Many changes are coming, and the following are some of the most predictable.

Expanding services impact the future of medical billing and coding

Recently, there has been a major paradigm shift in medical care. Physicians have turned to technologies such as telemedicine, artificial intelligence-based recording, smartphones, text messaging and dispatch tests to make diagnoses and deliver treatments. All of these areas will continue to expand and become an integral part of medical care.

Increased need for medical billing experts.

The way we bill for medical services, and even the way those services are reimbursed, are also undergoing changes. Services that once required significant overhead and in-office support are now being streamlined, and the use of remote or off-site medical coding and billing services is growing. This growth is expected to continue as medical front offices find a new balance, using trendy services and simple tools to help small medical practices redefine the needs of their clients.

The Bureau of Labor Statistics predicts that the need for trained medical billing and coding professionals will increase by 9% over the next decade. This is due in part to the growing population of the United States and the fact that Americans are living longer. 

Given the great need for medical billing experts, technological developments are taking center stage.

Artificial Intelligence

Artificial intelligence (AI) is beginning to change the way medical practices care for their patients, but more importantly, how billing codes are managed and reimbursed. More and more insurance carriers are using artificial intelligence to analyze large medical claims data sets for coding errors, anomalies, reimbursement fraud, and abuse.

Cloud-based medical billing services

Once a mysterious place filled with millions of data points, the cloud has made its way into the business world, but it has also become a trusted tool for healthcare delivery. Cloud-based services refer to the electronic storage and maintenance of software. The cloud allows access to data over the Internet while minimizing technology and staffing costs. 

In its infancy, the security of cloud-based medical billing software was questioned by practitioners. But third-party or cloud-based medical coding and billing services are trending. And thanks to significant advances in encryption technology, cloud-based medical billing and coding services are operational today and will be in the future. 

Focus on the patient as a consumer

The advent of the concept of the patient as the consumer has introduced a more human element to medical billing practices. Medical practices must now consider all aspects of consumer needs and expectations, requiring a more personalized approach than previous billing practices. 

Another aspect of the trend toward patients as consumers is the ongoing need to protect patient rights and comply with HIPAA privacy laws. These laws, which are constantly evolving, are designed to protect personal information. And while they are fundamentally necessary, the ongoing requirements are increasing the demands on already overburdened administrative staff in healthcare facilities large and small.

Meeting consumer needs will be an increasing trend in the future, and it is predicted that more and more small medical practices will use outside services to meet the associated requirements.

Revenue Cycle Management Outsourcing

Outsourcing medical billing, coding, revenue and communications management is different for every practice and medical specialty. What works well for a family practice may need to be adapted for a surgical team. Overall, however, revenue cycle management services enable providers to reduce costs, streamline billing and improve care while freeing up time and resources. 

The future of medical coding and billing trends shows that the healthcare industry is growing. With this growth comes an increase in the number of complex regulations and requirements placed on physicians. 

Let's not kid ourselves. It's hard to think about the future of your own business and profession when most fast-paced physician practices are just trying to manage the daily workload while providing quality care.

A recent survey found that more than 30% of physician practices, including hospitals, outsource medical billing and coding services. This year, the estimated global market for medical billing outsourcing surpassed $11 billion. 

And as providers increasingly recognize the need for and benefits of comprehensive revenue management, that number will continue to grow.

Electronic integration of the entire practice

Over the past two decades, electronic claims processing and medical billing have transformed healthcare. With few exceptions, state and federal laws now require providers to use electronic data management and benefit transfer systems. 

Medical billing software is essential for every practice. Providers encounter problems when their software is not integrated with other parts of their practice. And administrative staff struggle when online records still don't comply with e-prescribing laws. In fact, a lack of technology integration can cripple a physician's practice, or at least lead to costly errors.

In contrast, the time saved by implementing technology efficiently - whether it's integrated prescription transmission or patient communication - is invaluable.

Revenue cycle management vendors are expected to drive the future of medical billing and coding systems by creating seamless software integration, as practices large and small demand instant integration or comprehensive software packages.