a professor is explaining the future of medical billing to its student

The Future of Medical Billing, AI and Automation

The future of medical billing shows that the healthcare industry is growing. As it grows, so does the number of complex regulations and requirements governing practitioners. 

Let’s face it. It is hard to think about the future of your business and profession when most of you are just trying to get through the day’s workload while still providing quality care. 

It’s tough. 

However, the good news is that medical billing is expected to change in the future due to the use of emerging technologies, such as artificial intelligence (AI), automation, and blockchain technology.

In this blog, we are going to explore the history of medical billing, its evolution, and future predictions. By the end of this article, you will have a clear picture of the future of medical billing and what you exactly need to adopt to grow your practice. 

So, without any further ado, let’s dive into the world of medical billing!

How Did We Get Here?

Imagine trying to keep track of your doctor visits, tests, and bills on paper. That was the reality of medical billing in the past! It was slow, easy to lose, and prone to many errors.

Then came computers. Electronic Health Records (EHRs) replaced paper files, making it easier to find information and share it with insurance companies.

However, there was still a significant amount of manual work to be done. Tracking medical records manually was undeniably challenging.

It took considerable time for medical staff to review health records, separate treatments and procedures, assign costs, and prepare the final bill.

Today, advanced software and hardware allow for rapid billing processes, with results available almost instantly. Consequently, healthcare facilities that do not adopt medical billing software risk falling behind.

From Paper to Digital: The Advent of Electronic Health Records

The Regenstrief Institute introduced the first electronic medical records (EMR) in 1972, marking a major leap forward for the healthcare sector.

However, due to the high costs, this innovation did not gain widespread adoption initially.

It wasn’t until the American Recovery and Reinvestment Act of 2009, which included incentives for adopting EMRs, that medical facilities began transitioning to digital records.

Are EMR and EHR the Same?

While the terms EMR (Electronic Medical Record) and EHR (Electronic Health Record) are often used interchangeably and refer to similar systems, there is a distinction.

EHR is a broader term that encompasses a wider range of health information, while EMR is more specific to individual practices.

For most healthcare providers, both terms represent the important shift from paper-based records to digital systems. The widespread adoption of EHR and EMR systems is essential for advancing healthcare as a whole.

Where Are We Now?

Changes can also be seen in how we bill for medical care and even how those services are reimbursed.

Services that previously required significant overhead and in-practice support are being streamlined, and remote or third-party medical coding and billing services are growing.

That growth is expected to continue as medical front offices find a new equilibrium, embracing trending services and simple tools to help small medical practices redefine their customers’ needs.

The Bureau of Labor Statistics forecasts that the need for trained medical billing and coding experts will grow by 9% over the next decade.

This is partly due to a growing United States population and the fact that Americans are living longer.

With a strong need for medical bills, technological developments take center stage.

Within the past two decades, electronic claims processing and medical billing have transformed the healthcare industry.

With few exceptions, state and federal laws now require providers to utilize electronic records management and claim transmission systems.

Today, we have special software that helps with medical billing. It’s like a smart helper that does a lot of the boring work. 

What Are the Benefits of Electronic Health Records?

EHRs are crucial for managing and accessing patient medical histories effectively. Their benefits include:

  • Facilitating communication between healthcare providers across different settings and providing quick access to patient records.
  • Automatically detecting and alerting healthcare professionals about medication allergies and potential drug interactions.
  • Enabling doctors to swiftly review a patient’s extensive medical history.
  • Minimizing errors caused by poor communication or illegible handwriting.

For instance, when a physician needs to assess the best treatment for a patient’s new symptoms, EHRs enable them to easily review years of medical history. The system may also suggest treatment options or indicate if a proposed treatment is unsuitable. Additionally, EHRs can alert the doctor to potential drug interactions or allergies and check whether the treatment is covered by insurance. The doctor can then send the prescription or order electronically.

When used effectively, EHRs enhance patient care by making management more efficient and accurate.

What Are the Different Types of Electronic Health Records?

EHRs are used across various healthcare environments, including

  • Primary care providers such as doctors, nurse practitioners, and physician assistants
  • Medical groups with multiple locations and specialities
  • Hospitals and urgent care facilities
  • Health and dental insurance companies
  • Pharmacies
  • Laboratories

What’s next for Medical Billing?

Medical billing is about to change significantly due to new technology and evolving industry needs. Here’s what to expect:

1. Increased Automation

Automation will revolutionize medical billing by making it more efficient and cutting down on mistakes.

  • Error Detection and Correction: Automated systems will increasingly handle routine tasks, such as spotting and fixing errors in billing codes. It means fewer mistakes and more accurate billing.
  • Claims Processing: It will speed up the claims submission process, leading to quicker reimbursements for healthcare providers and fewer patient delays.
  • Reminders and Notifications: Automated reminders will help both patients and providers stay on top of important billing dates, like payment deadlines and upcoming appointments.

2. Artificial Intelligence (AI)

Artificial intelligence (AI) is beginning to change not only how medical offices provide care but, more importantly, how billing codes are managed and reimbursed.

An increasing number of insurance payers are using artificial intelligence to analyze large medical claims data sets for coding errors, anomalies, reimbursement fraud, and abuse.

Here’s how AI will play a big role in improving medical billing:

  • Predictive Analytics: AI will analyze past billing data to estimate potential issues before they occur. It includes spotting patterns that might lead to claim denials or disputes.
  • Cost Savings: AI will optimize billing practices by suggesting more efficient coding and practices, helping providers save money.
  • Fraud Detection: Advanced AI will detect fraud by identifying unusual patterns and anomalies in billing data, helping to prevent fraudulent activities.

CONCLUSION

Healthcare is not going back to the days when billing, or any other process, was done manually. Instead, it is destined for a future in which AI and machine learning will become commonplace.

So, the future of medical billing is bright. These new technologies promise to make the system more efficient, accurate, and secure. The good thing? It benefits everyone involved.

text contains top 5 medical billing companies with a girl ensuring that its true

Top 5 Medical Billing Companies

What is Medical Billing?

Medical billing involves submitting health insurance claims on behalf of patients to insurance providers to receive payment for healthcare services rendered.

It involves creating invoices for services rendered to patients, a process known as the billing cycle or Revenue Cycle Management (RCM). RCM encompasses the entire revenue collection process for a healthcare facility, beginning with the design of the RCM workflow.

This process may span from a few days to several months, often requiring multiple interactions before achieving resolution.

The relationship between healthcare providers and insurance companies resembles that of vendor and subcontractor: healthcare providers contract with insurers to deliver services to covered patients.

What is Medical Coding?

Medical coding is the process of translating patient health information, like diagnoses, procedures, and services, into universal numerical or alphanumeric codes.

These codes are used for medical billing and to track health trends. Essentially, coders convert the information from a physician’s notes or other medical records into a standardized format that insurance companies and other healthcare providers can understand.

Medical coding’s primary use is to ensure medical billing and insurance carriers pay and process claims correctly.

Moreover, the system is valuable for research purposes and basic medical record-keeping for patients.

Each code tells insurance companies, researchers, and healthcare providers the exact diagnosis, procedure, and/or medical service provided.

In short, these codes act as a universal way to quantify healthcare visits and make physician’s notes less abstract for insurance carriers and future health providers.

Are Medical Coding and Medical Billing the same?

No, medical coding and medical billing are distinct, although related, processes in the healthcare industry.

Medical coding focuses on assigning codes to medical procedures and diagnoses, while medical billing involves submitting claims to insurance companies and ensuring proper payment.

How does Medical Billing work?

The medical billing process

While the medical billing cycle comprises numerous steps that can take anywhere from a few days to several months, accurate billing and timely follow-up are the No. 1 priorities.

Most states require insurance companies to pay claims within 30 or 45 days.

Conversely, payers impose claim filing deadlines that, when missed, nullify coverage. The late claim is denied without the option to appeal, and the organization forfeits reimbursement.

Errors occurring at any stage in the billing cycle can prove costly in terms of revenue and administrative workload, which underscores the value of medical billers able to command their role in the billing process.

The financial health of physician practices and provider organizations, such as hospitals, health systems, and surgery centers, depends on the effectiveness of front-end and back-end billing staff.

Front-end & back-end medical billing

The medical billing process can be broken down into stages, what’s known as front-end and back-end.

  • Front-end billing takes place pre-service — or before the patient sees the doctor. This stage involves the front-office staff and includes all the patient-facing activities on which accurate billing depends.
  • Back-end billing occurs after the provider sees the patient. Once the medical coder completes their responsibilities and the billing staff have access to the medical codes that represent the patient encounter, the billing process resumes in the back office, which means that back-end activities are not patient-facing.

Best Medical Billing Companies

Top medical billing companies that help doctors and hospitals get paid faster and more accurately.

  1. CureMD – Helping doctors manage their practices with ease.
  2. Oracle Health – Smarter healthcare solutions for better patient care.
  3. XyberMed – Making medical billing faster and easier.
  4. Kareo – Simplifying medical billing for healthcare providers.
  5. BellMedEx – Expert medical billing services for smooth operations.

CureMD

CureMD is a renowned healthcare technology company that provides innovative solutions for electronic health records (EHR), practice management, medical billing, and population health management.

With its state-of-the-art platform, CureMD has gained recognition for its award-winning EHR system, which has transformed the way healthcare professionals manage patient information and deliver care.

CureMD’s EHR platform offers a comprehensive suite of features designed to streamline clinical workflows, enhance patient care, and improve overall operational efficiency.

The system combines advanced technology with intuitive design, allowing healthcare providers to easily access, update, and share patient information securely and efficiently.

Oracle Health

Oracle Health offers a range of solutions and services for healthcare providers, including electronic health record (EHR) solutions, seamless exchange of patient data, and community and CAH (Community and Accountable Healthcare) solutions.

They are a leading provider of EHR solutions worldwide. Oracle Health also focuses on enterprise solutions like Healthcare ERP for finance and operations and cloud infrastructure for healthcare workloads.

XyberMed

XyberMed is a privately held company founded in 2013, offering various healthcare solutions. It specializes in medical billing, revenue cycle management (RCM), healthcare IT solutions, and related services.

Their services include pre-authorization, medical credentialing, front-office solutions, and digital marketing.

XyberMed simplifies medical billing through advanced technology. They help doctors and hospitals get paid faster, cut down on paperwork, and focus on treating patients.

With experts handling billing, coding, and claims, healthcare providers can focus on patient care.

Partnering with XyberMed means less stress, more efficiency, and better care for patients.

Kareo

Kareo helps doctors and medical practices get organized, get paid faster, and focus on patient care.

Their easy-to-use tools simplify billing, scheduling, and patient communication so healthcare providers can do what they do best – care for patients.

Kareo’s billing services help providers get paid faster and more accurately.

Their practice management software streamlines scheduling, patient communication, and administrative tasks.

Kareo’s patient engagement tools enable providers to communicate effectively with patients, improving patient satisfaction and outcomes.

Kareo’s solutions aim to simplify healthcare administration, reduce stress, and increase efficiency, allowing providers to focus on delivering high-quality patient care.

BellMedEx

BellMedEx is a medical billing company that helps doctors and healthcare providers get paid for their services. They handle all the paperwork, coding, and claims so providers can focus on patient care.

With BellMedEx, healthcare providers can expect increased revenue, reduced administrative stress, and improved accuracy.

Their team of experts uses advanced technology to manage billing and claims, providing transparent reporting and dedicated support.

By outsourcing billing to BellMedEx, healthcare providers can simplify their financial management and focus on delivering quality care to their patients.

CONCLUSION

Medical billing and coding are essential for healthcare providers’ success. Companies like CureMD, Oracle Health, Kareo, and BellMedEx offer valuable solutions and are good choices.

However, XyberMed stands out for its innovative approach, leveraging smart technology to simplify billing, reduce stress, and increase efficiency.

With XyberMed, providers can trust their financial processes are in capable hands, allowing them to focus entirely on delivering outstanding patient care. This makes XyberMed a top choice among competitors

 

20

Emerging Technologies in Medical Billing

Healthcare providers used to face claim denials and poor patient management in the past. However, emerging technologies in medical billing has not only improved RCM but also enable to identify and prevent future problems. The healthcare industry is growing rapidly and the need of adopting emerging technology is imperative for healthcare providers.

If you’re a healthcare provider this blog is for you. Coming up next, we will talk about all the emerging trends revolutionizing the health industry.

Rise of AI and Machine Learning

AI is the most revolutionizing technologies in medical billing making it easier for healthcare providers to manage their records and finances efficiently. In healthcare industry, handling patient’s data is the most critical yet difficult aspect. At the time of claims, errors in patient data is the leading causes of rejection but with AI, this fear is over.

Additionally, handling unseen troubles is another thing to take care of in healthcare. Therefore, machine learning technology is introduced to predict future problems and resolve them before happening.

Blockchain Security

You might know blockchain is related to cryptocurrency however, the influence of blockchain security in medical billing is remarkable. With that said, it is the following technology that has made finance management easy for healthcare providers. Blockchain technology provides a decentralized system that offer transparent billing protocol and secures patient data efficiently.

Cloud-Based Systems

Cloud-based system is on the rise in the healthcare industry to make documentation convenient. Now providers can get a cloud-based system to handle tiring paperwork. It enables providers and patients to access the billing system anytime, anywhere. This entire smart documentation platform gives the freedom from bulky paperwork. On top of that, the entire system is protected with back up eliminating the fear of losing it.

Automation

Automation is one of the most adopted technologies in medical billing to conduct petty tasks itself like claim submissions and insurance verification. Earlier, healthcare providers used to perform these tasks manually and the denial ratio was high. With the help of automation technology, the chances of human errors have dropped to major extent which means less denials and more revenue.

Natural Language Processing (NLP)

Often healthcare providers have to analyze long documents and import important information. However, NLP caters to this process efficiently as it thoroughly analyzes, understand and interpret worthy information from clinical documents. This has reduced human efforts to major extent and handle unstructured documents for accurate coding and billing.

Wearables

Next technology we have on our list is wearables devices like smartwatches to monitor patient. This helps in obtaining important data for better diagnosis, preventive care and imbursements. Healthcare providers cannot only provide proper care but they’ll be able to handle patient’s data efficiently. This smart move will help them at the stage claims with minimal errors possibility.

Patient Portal Apps

Creating ease for patients will not only help you improve finances but also get patient loyalty. Patients need clarification when it comes to clearing bills therefore patient portal apps are introduced by technology. These apps contain all the details of bills that help them understand charges and similarly, they can pay by one click away.

Moreover, portal apps help patients engage in chats instantly to get answers toof their questions. Resultantly, portal apps assistassists you with an efficient chat support system.

Telemedicine

With Telemedicine technology, doctors can consult with patients, provide prescriptions, and even monitor ongoing conditions, all without needing to meet in person.

This approach has completely changed how healthcare is delivered. Remote consultations, virtual check-ups, and treatments are now more accessible than ever, especially for those in remote areas or with mobility challenges.

But as telemedicine grows, it’s shaking up the medical billing world too. Billing systems must now keep up with virtual visits, remote patient monitoring, and other telehealth services. This means updating codes, processes, and compliance to ensure everything runs smoothly.

In a nutshell, Telemedicine isn’t just about comfort; it’s a revolution for how healthcare is managed and delivered.

Future of Technologies in Medical Billing

The future of technologies in medical billing is promising. With continuous advancements, the healthcare industry is growing gradually and the revenue management cycle is better more than ever. Aspects like denial management, coding, management has become convenient for providers to handle and in future, efficiency is predicted to increase immensely.

The efficiency of the following technologies will increase in the future.

  • Artificial Intelligence will make billing smoother and nearly error-free.
  • Blockchain will ensure secure, tamper-proof records, making fraud a thing of the past while boosting trust among providers, insurers, and patients.
  • More apps will be introduced so patients can track bills and make payments smoothly.
  • Virtual healthcare will become mainstream for smart billing systems.

Hire Xybermed for Efficient Technologies in Medical Billing

How about having the assistance of technology experts that are experienced in medical billing? Introducing you Xybermed which works as a bridge between healthcare providers and financial institutes. At Xybermed, we provide all the tech-based services including front desk solutions, denial management, credentials, and pre-authorization.

Handling technology requires expertise therefore, by outsourcing the administration in the hands of experts you’ll be able to focus on other important corners like care. Visit Xybermed to get a quote.