Developed and developing economies are expected to see health care spending increase ranging from 2.4 percent to 7.5 percent between the year 2015 and 2020 according to the report by Deloitte. Healthcare industry is projected to take a multi-million dollar leap by 2022; Are the existing resources in the industry enough to meet the projected demands? The industry in general has been facing a lot of issues regarding the billing processes including changes in maintaining health care records and the changes in Medicaid and Medicare policies. Also, operational costs are increasing in the medical industry more than ever, providing diminishing returns. Complicated coding rules, fee structure confusions, Value for care focused policies are some of the major struggles that the industry is battling.
Experts have appointed 2017 as the harbinger of change. Significant transition is expected in the healthcare billing sector this year. Advancements in the medical billing and coding departments are likely to make the job a new look. Let us have a look at the most important healthcare billing trends that will affect the healthcare industry in 2017.
Trend I: Transition from ICD-9 to ICD-10
The coding system saw an upgrade in October 2015 through transition to International Classification of Disease (ICD-10). This new ICD-10 has approximately 69,823 codes & 71,924 procedure codes. Additionally, 140,000 new codes have been added to the list. The new coding system offers extensive structural changes compared to ICD-9. Coders are required to attend training sessions to adapt to the increased level of complexity. It’s time that coders adapt themselves to the newly introduced changes and remains their efficient best. For Example, CMS activated two current procedural terminology codes that pay for prolonged E/M services before and/or after direct patient care that do not require direct face-to-face patent interaction namely, Code: 99358 & Code 99359.
Trend II: Implementation of CPT codes
The Current Procedural Terminology (popularly known as CPT) medical billing codes are crucial instruments when it comes to the process of reimbursement. CPT codes have been designed to replace the names of the services performed by the practitioner on each patient. These may include evaluation of the condition of the patient, surgical procedures or even diagnostic services. CPT codes are known for their transient nature and get upgraded almost every six months. The very beginning of 2017 saw the implementation of new CPT codes to avoid any risk of incorrect coding and delay in backup for patients and doctors. Changes have been made in cardiovascular surgery codes, new biochemical codes, conscious sedation changes, psychotherapy changes and pathology and laboratory changes.
Trend III: Electronic Health Records Management
Health care industry has seen a massive boom when it comes to technological advancement. Recently, electronic health records (EHR) implementation and management has seen a revolution. It is estimated that Cloud technology for Electronic Health Records will improve along with implementation of a nationalized electronic patient database. Experts are of the view that adopting HER software will become mandatory for every healthcare provider.
Trend IV: The Rise of Money Managers in Healthcare
Going by the trends, we can see that consumers are growing conscious about their health care spending. They are finding it important to manage health spending just like they manage their savings and retirement funds. This projects that companies will have to start linking healthcare payments and billing with broader and welcoming consumer experience, or bundle financing with other offerings to solve payment problems, and provide greater convenience and value to the customers.
Trend V: Cognitive Computing
Cognitive computing simulates human thought processes in a computerized model. Through deep learning algorithms that use data mining, pattern recognition and natural language processing, the computer can mimic the way the human brain works. In 2017, we are more likely to hear terms such as “cognitive computing” and “artificial intelligence” (A.I.).
Trend VI: Block Chain
Highly popular today in the healthcare sector today, Block chain is a peer-to-peer distributed ledger technology. It allows for medical businesses to digitize transaction workflow through shared and replicated ledger. Block chain technology organizes data so that transactions can be verified through the consensus of all parties involved therein. Tis may vary from individual’s personal health record to financial payments. It ensures greater accuracy. In healthcare, a patient’s record can thus be validated and errors reduced. The technology ensures that the security is enhanced and chances of misuse greatly lessened. Block chain is a promising technology and has the potential to bring about positive changes in areas like identity and medical billing fraud.