Medical Coding and Billing Trends Impacting Your Organization
Valerion Health
September 21, 2023
The healthcare industry is rapidly evolving with prevalent situations like labor shortages and mounting expenses becoming an increasing concern. Additionally, other relevant challenges like inflation and skyrocketing costs of high-deductible plans impact the patient’s ability to spend. According to a study, over 25% of adults are skipping medicine or care due to its rising cost.
According to a poll conducted by Medical Group Management Association (MGMA) in August 2022, 56% of medical practices reported that they spent more days managing accounts receivable (A/R) in 2022 than in 2021. An increase in the number of days spent in A/R can hinder the organization’s cash flow and growth. To solve this problem, healthcare organizations’ managing departments are looking to outsource time-consuming and complex tasks such as medical billing and coding. This would also help reduce the pressure on the internal staff and enable them to focus on patient care.
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The healthcare industry is rapidly evolving with prevalent situations like labor shortages and mounting expenses becoming an increasing concern. Additionally, other relevant challenges like inflation and skyrocketing costs of high-deductible plans impact the patient’s ability to spend. According to a study, over 25% of adults are skipping medicine or care due to its rising cost.
According to a poll conducted by Medical Group Management Association (MGMA) in August 2022, 56% of medical practices reported that they spent more days managing accounts receivable (A/R) in 2022 than in 2021. An increase in the number of days spent in A/R can hinder the organization’s cash flow and growth. To solve this problem, healthcare organizations’ managing departments are looking to outsource time-consuming and complex tasks such as medical billing and coding. This would also help reduce the pressure on the internal staff and enable them to focus on patient care.
What is Trending in the World of Medical Billing and Coding
The healthcare sector is vastly changing due to public health concerns, new laws and procedures. These trends will have a huge impact on the patients as well as on industry professionals. Here is a look at the latest medical coding trends and other factors that can affect your RCM practices.
- Keeping Up with ICD-10 Guidelines The International Classification of Diseases (ICD) is essential for global healthcare analysis, providing codes and guidelines to communicate with healthcare professionals worldwide. These codes are crucial for resource allocation and securing insurance reimbursements. It is important to make sure that coders are able to assign accurate codes to minimize billing errors.
- Improving Patient Experience Negative billing experiences can significantly decrease overall patient satisfaction. Being persistent and proactive in informing patients about payment options, digitizing payments for convenience, effectively managing bills with the latest software can enhance patient experience. Collaborating with certified professionals can help reduce errors in medical billing while also increasing trust and fostering lasting bonds with patients
- Cybersecurity Compliance Diligent data protection measures ensure security of Patient Health Information (PHI). Unauthorized access could invite legal penalties and reputation damage while compromising your patients’ personal data. You should ensure that your outsourcing partner is HIPAA-compliant and know how to effectively handle data and manage confidentiality
- Analyzing the Underpayment Issue Various factors contribute to underpayment, including coding errors, inadequate reimbursement rates, denied payments, and insurance network constraints. The underpayment issue can affect your organization’s financial viability and your ability to deliver high-quality care. Several healthcare organizations are addressing underpayment issues by teaming up with outsourcing partners to identify and rectify denied claims. A reliable outsourcing partner will have a team of specialists who can help improve coding practices and better reimbursement terms and systems
- Increased Outsourcing Recent medical billing trends suggest healthcare organizations are increasingly outsourcing coding and billing processes to skilled professionals to cut expenses and enhance efficiency and productivity. This enables in-house staff to focus on patient care. Additionally, it helps streamline operations and promotes growth
- Training and Education Coding and billing are evolving sectors where the regulations are updated from time to time. Your team must keep up with the latest developments to ensure your operations remain up to date. The right training and education programs can enhance your staff’s knowledge and enable them to stay on top of industry updates. A trusted outsourcing partner like Valerion Health offers basic to advanced level training and provides AHIMA and AAPC continuing education credit upon completion of educational material
According to a report by Acumen Research and Consulting, the global medical billing outsourcing market, valued at $11,748 million in 2021, is projected to reach $ 30,157 million by 2030, growing at an annual rate of 11.3% from 2022 to 2030. This growth is driven by various factors like increased regulatory focus on risk and compliance, the need for more efficient billing systems and cost-saving efforts.
Why should you work with us?
At Valerion Health, we are dedicated to empowering healthcare providers in their mission to enhance patient lives through efficient business operations. Backed with years of industry experience, we recognize the uniqueness of each healthcare business and understand your hurdles. Additionally, we provide customized solutions to match your specific objectives and requirements.
Leverage our range of solutions, from medical billing, coding and denial management to educational solutions and revenue cycle management solutions. Your healthcare organization can benefit from the expertise of our team that has been a part of the industry for over two decades. To know more, contact us today.
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