Will 2016 bring more Challenges in Medical Billing?



Constant changes take place in the healthcare industry with respect to codes, rules and standards. As 2015 saw the introduction of ICD-10, the knowledge of these codes along with other challenges shall unquestionably be carried forward to 2016. So how does the medical billing industry stay abreast and prepare themselves for such challenges? Here’s what the medical billing team might want to know:

1. Staff: This is a boom time for the practice management system. Many healthcare providers are moving on to outsourcing their medical billing and coding requirements. Hence, a large technically qualified staff is required to solve all the revenue cycle management matters effectively. This includes addition of certifications and trainings for employees. As per Bureau of Labor Statistics, the job growth is going to be approximately 22% by 2022 for medical billing technicians. After a look at budgeting, training requirements and other tax related matters, recruitments will see an increase in this industry.

2. Changing regulations: ICD-9 to ICD-10 is a huge change and a one-year grace period has been given for slip-ups by CMS (to comply with). But the medical billing and coding industry needs to be well aware of these changes quickly and proficiently to avoid flaws in billing; along with staying abreast of changes in the regulations which consistently change.

3. Software: Electronic Health Records (EHR) is now becoming the standard in the medical billing industry. However, many healthcare providers are still doing paperwork wherein some are doing a mix which does not let steady and adept processes subsist. Hence regular training is required to keep the medical billing technicians well informed of all the forms/versions of software and technology which shall further improve not only efficiency but also enhance customer satisfaction.

4. Payments: Over 85% of healthcare providers agree with the fact that many times it is not easy to track patients to make payments. It won’t be any easier in 2016; however, with the advent of mobile device friendly patient portals, making payments could be made easier for patients. This also adds to the need of supplementing yet another process for enhancing the need of exact and timely medical billing solutions.

5. Focus: Going forward, it is recommended that all the necessary demographics are collected as soon as the patient walks in the healthcare facility including payer details, and diligently verify them. If the patient is not covered, communicate early the coverage options/what they owe to the hospital thereafter and incorporate flexible payment alternatives. Focus on cash collection at the point-of-service.

Keeping up with developments in the ever changing medical billing and coding field can be overwhelming. It can be safely said that despite challenges, the medical billing industry is looking at a rapid growth that could bring increasing challenges in this year.

This entry was posted in EMR / EHR / Health IT, ICD-10, ICD-10 Coding, Medical Billing. Bookmark the permalink.


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