New government regulations and payment methodologies, constantly changing medical codes and other reform measures have made the medical billing process prone to errors. Recent reports say that an estimated 30 to 40 percent of medical bills containing errors. Physician practices and the medical billing companies that serve them need to be alert to medical billing and coding errors, which can lead to losses amounting to thousands of dollars for both providers and patients. The good news is that artificial intelligence (AI) can play an important role in improving healthcare revenue cycle management.

  • CNBC recently reported on how AI is set to transform medicine – from coding to cancer – by improving medical diagnosis. According to the report, Massachusetts General Hospital is examining the potential of computers to diagnose breast cancer early in mammograms and whether AI can help physicians use the huge volumes of patient data to make more personalized therapeutic decisions. In fact, experts are now training computers to comb digital slides, and learn how to differentiate cells that are cancerous from healthy ones.
  • The article also describes a novel system known as Deep Patient that allows researchers to scour de-identified health data across the hospital system and combining information different ways to better predict diseases from schizophrenia to cancer to severe diabetes.
  • According to a new Health Data Management report, the use of next-generation automation tools can improve resource utilization and support quality improvement to meet Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) goals.
  • Innovative automation tools can also help accurately code and classify all diagnoses, symptoms and procedures. Natural language processing offers tools to extract accurate ICD-10 codes by mapping the physician’s consultation notes against a multi-level medical dictionary. This can minimize recovery audit risks and associated costs.
  • Experienced medical billing and coding service providers already use advanced technology to help medical practitioners manage patient appointment scheduling and claims processing. Automating scheduling and sending appointment reminders to patients reduces the chances of missed appointments, driving efficiency and improving revenue cycle management. AI-enabled automated systems can help organizations track and improve performance on key healthcare metrics.
  • With the increasing number of patients and the dynamic healthcare scenario, healthcare providers need more accurate and efficient back-end systems. For instance, bundled payments are an innovative alternative payment model that represents a great opportunity for the use of information technology. Providers will need to fully optimize information systems to manage bundled payment requirements, provide value-based care, and receive appropriate reimbursement.

Medical billing outsourcing can help providers exploit the power of automation and concentrate on providing patients the treatments they deserve. A technologically advanced medical billing and coding company would use the latest billing software in a way that it easily bridges the gap between the provider and the biller. With changing codes, payer rules, and new technologies, the support of an experienced service provider can prove invaluable to drive transformation, revenue and improved care.