How AI is rewriting Medical Coding Automation

By: exdionrcm

The importance of Artificial Intelligence in today’s world can never be overstated. If implemented efficiently, AI has the potential to boost your coding and billing business tenfold. On many occasions, it can be argued that AI has actually helped scale business better than the physical workforce. 

So how has AI changed the way healthcare providers and insurance agencies  work? This blog will shed more light on it. For starters, let’s look at how a traditional Medical billing and coding process flows.

How a Traditional Billing and Coding Process Flows?

The traditional billing process involves a lot of paperwork and manual documentation. The paper claim is very time consuming, with coders having to enter each code individually in printed forms. These paper forms are first passed on to the medical billing organization, and subsequently to the payers.

In a paper-based setup, the average turnaround time, right from filing a claim to receiving payments takes between 5 to 7 weeks. Automating the medical billing system can bring that time right down to 2 weeks. 

Steps in a paper-based claim:

  • Patient visits healthcare facility or physician
  • Patient checks-in and gets treatment
  • Doctor or assistant writes a superbill 
  • Medical coder adds treatment codes
  • Paper forms with coding are sent to medical billing department that  formats  and sends this data to  the insurance agency
  • The insurance agency generates a check and sends the payment to the provider

This is a long, time-consuming process when done manually. The use of AI can boost the medical coding process and save a significant amount of time.        

How AI will boost the medical billing process

The biggest challenge faced by coders today is managing coding accuracy. To improve the efficiency of billing and coding, many healthcare providers are finding ways to simplify manual coding through the application of AI. Computer Assisted Coding (CAC) uses a combination of Machine Learning and Natural Language Processing (NLP) to automatically identify, extract and insert data from the documents  into the system. Beyond processing codes and high volumes of data, AI can also lessen the effort involved in auditing and cross checking  while reducing errors from creeping in.

What problems will AI solve?

The inherently complex nature of the medical billing and coding process makes it prone to  errors. Some of these errors can cause considerably high revenue losses. Coders usually spend most of their  time executing menial tasks that could be done swiftly and efficiently using AI packed Robotic Process Automation.

The future will see the deployment of more intelligent technologies such as deep learning, optical character recognition, voice transcription and AI-backed coding automation.

Using database backed Medical coding repositories and AI will enable faster  rectification of erroneous billing. When this process is done manually, it is a lengthy, bureaucratic  and complicated procedure that is costly. By deploying AI, healthcare providers and insurance agencies can spot errors immediately and mitigate them.

Wrapping up

ExdionRCM’s Coding, Billing, Payment Posting & AR automation solutions from Exdion, automates the billing and coding process to give great results. It is built on a proprietary rule-based engine which automatically scrubs and flags errors immediately. Implementing ExdionRCM automation services will help you improve provider accuracy, reduce manual billing and coding errors while capturing all missed charges. Get Started with ExdionRCM and watch your revenue grow.

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