Wednesday, April 3, 2024

Medical Billing and Coding Trends 2021

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Top Trends in Medical Billing and Coding 2021

Medical billing and coding trends are assisting healthcare professionals in overcoming day-to-day issues. One of the critical reasons for the healthcare industry’s reluctance to accept technology is patient safety. However, the laws governing medical billing and coding and the codes themselves are updated regularly, and new codes are issued occasionally. 

Therefore, to boost the bottom line of any institution, professionals and their billing staff or collaborating medical coding businesses must stay current on the latest trends. Embracing these improvements can also assist each practice by ensuring on-time reimbursement, avoiding claim denials, and increasing income.



So today we are going to discuss medical billing and coding trends in 2021 that every medical biller or medical coder should know. So here we go!

For over a year, the COVID-19 epidemic has dominated the news. Because it has had such a significant influence on the healthcare business, every practitioner is raising the same question: “What are the most recent medical billing and coding trends, and how would they help us overcome the obstacles of this pandemic?”. However, the concern with these medical billing and coding trends is that they could represent a risk to professionals. In addition, these medical billing and coding trends may not be advantageous in the long term. 

Recent medical billing and coding trends are bringing in a novel standard for medical Revenue Cycle Management, allowing medical businesses to recover from the unprecedented worldwide crisis and transition to value-based care. Each year, changes in Medicare and Medicaid laws, complicated and stringent coding standards, increasing technology alternatives, and other obstacles complicate the billing process for clinics.

Those medical practices have adopted new trends and conventions in order to achieve the digital revolution, but there are still many who lag behind. So if you wish to be involved in medical coding or billing, you must embrace these modern medical billing and coding trends and developments as soon as possible to improve their Revenue Cycle and patient satisfaction.

According to the CMS (Centers for Medical and Medicaid Services), health spending in the United States will reach an astounding 5.7 trillion dollars by 2026. Because the healthcare industry is as large as it depends on public and private payers, providers must comply with tight guidelines to maintain profitability. Professionals need to stay up to date on current medical billing and coding trends in order to optimize the process and be completely reimbursed for their services.


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Top 5 medical billing and coding trends in the industry 

Here there are five medical billing and coding trends to look out for in 2021. So let’s go through each of the trends.

1. Medical Billing Outsourcing Market to Expand

In-house medical billing entails practice employees controlling all parts of revenue cycle management, including submitting claims for reimbursement, setting charges, collecting patient payments, and managing accounts receivables. A medical billing service performs such responsibilities through outsourced medical billing, generally in exchange for a portion of a practice’s collections.

Medical billing is one of the most challenging and crucial jobs of a medical business. Revenue cycle management entails several complex duties and processes such as patient scheduling, insurance validation claims management, AR follow-ups, payment collection, etc.

Several medical services providers view medical billing outsourcing as a viable alternative to optimize the processes and synchronize the total billing and administration operations in order to focus more on patient care and satisfaction.

The healthcare sector is now seeing a rise in the usage of outsourced medical billing services by health facilities and professionals. Owing to complex ICD-10 coding systems, rising healthcare expenses, and a state needs to use electronic medical records (EMR) to maintain payment levels.

As a result, various analyses have been released, outlining the worldwide market’s anticipated expansion. According to Grand View Research, Inc., the worldwide medical billing outsourcing market will reach USD 23.1 billion by 2027, growing at a CAGR of 12.3 percent.

As we detailed in recent articles, it also provides superior savings, earnings, control, industry intelligence, and consistency. These are just a few of the reasons why the medical billing outsourcing business is thriving.

Medical billing and coding outsourcing assists practices in the following ways:

  • Concentrate on the fundamentals.
  • Obtain a cost-cutting measure.
  • Encourage development.
  • Balanced AR (account receivables)
  • Keep operational control.
  • Allow your employees some leeway.
  • Reimbursement on time.
  • Assist with risk management and continuity.
  • Internal personnel can benefit from professional development.
  • Increase productivity.
  • Cut down on income leakage.

2. Blockchain

The other medical billing and coding trends are Blockchain. Blockchain is one of nowadays’ influential technologies that has made a significant contribution in practically every work sector, providing an effective answer to the issues encountered. The medical business has also benefited from it.

Medical billing systems are undeniably complex and prone to significant billing mistakes. Nonetheless, blockchain technology provides high-end solutions for wrong filings, billing code problems, process duplication, and more through distributed ledger technology. In addition, it aids in creating accurate data records that may be shared with networked database systems and provides total transparency by presenting evidence of completed transactions.

Furthermore, the technology helps to ensure data integrity and helps preserve medical information (electronic health records, patient data) from threats/breaches. Because its methodologies are highly encrypted and store data in a format that cannot be customized until it has been authenticated by all participants in the system and achieves the ultimate recipient

3. Medical Billing Automation

In the medical billing industry, automation refers to duties such as claim filing and other critical components of the process that are handled by cloud-based software. Artificial intelligence (AI) minimizes the likelihood of medical claim mistakes and payment delays and rejections.

The main office employees will have more capacity for patient interaction and patient responsibility due to correctly implemented automation, which will boost the patient experience. In addition, automated systems can emphasize patient engagement with healthcare providers.

However, in order to adopt this type of billing system, practitioners must be skilled in the use of AI technology. Instead, businesses can delegate their billing and claim filling responsibilities to competent medical billing and coding firms.

A growing number of providers are using automation to manage administrative duties and improve data accuracy. Aside from time savings, automated medical billing reduces payment delays and rejections, provides more extensive reporting, more detailed documentation, and allows employees to complete more work in a shorter.

4. Integration of electronic health records (EHR)

According to 2020 medical billing trends, service providers are seeking suppliers who offer extensive software interoperability, allowing them to have a clear grasp of their job assignments. They are also kept up to speed on the most recent billing environment developments.

The billing software is integrated with the electronic health record to enable digital payments through a patient portal as well as integrated payment updates for the practitioner’s management system.

The benefits of combining medical billing systems with EHR software are numerous, ranging from comprehensive reporting to the ability to do digital payment processing through patient portals. Other advantages include increased efficiency by eliminating the need to fax or make copies of every billing document; increased representativeness by allowing access to data from a single location; lower coding errors through clean and efficient claims; and reduction paperwork due to the exclusion of manually filling out forms.

5. CPT (Current Procedural Terminology) Codes:

The other medical billing and coding trends are, Current Procedural Terminology (CPT) codes provide information about new billing breakthroughs in medical practice. In addition, the CPT codes feature remote health care viewing codes, which will allow the professional to use novel billing trends to engage with their patients remotely.

Further, there are successful trending consultation protocols that prioritize the use of communication technology in inpatient care. There are also advancements, including adaptive behavior analytics, nerve evaluations, and skin biopsies.

The American Medical Association (AMA), for example, has issued new CPT codes for SARS-CoV-2 vaccination. These six Category I numbers were used to document the COVID-19 vaccine: 0001A, 0002A, 0011A, 0012A, 91300, and 91301. The AMA has also established four new CPT codes for reporting COVID-19 laboratory testing: 86408, 86409, 0225U, and 0226U. It is critical to be up to date on changing codes, documentation requirements, and payment options to succeed with any specialized billing.

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I am a medical biller, a blogger and have 20 years of experience in medical billing, medical billing management, and medical assistant. My background includes positions as a clinical medical assistant, medical records technician, medical office manager, biller, and coder. I am certified by the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC) and by the Practice Management Institute (PMI) as a Certified Medical Office Manager (CMOM). As an office manager/biller/coder, I was a member of the Michigan Medical Group Managers, Michigan Medical Billers Association. I also served as a committee member of the Michigan Osteopathic Association of Practice Managers Education Committee.

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