Outsource Strategies International is an experienced medical billing company in the U.S, providing services for individual physicians, medical practices, clinics and hospitals. Our expert team is up to date with coding and billing rules for various medical specialties.

In today’s podcast, Meghann Drella, our Senior Solutions Manager, discusses “Top Medical Billing and Coding Trends for 2021”.

Hello and welcome to our podcast series. My name is Meghann Drella and I'm a Senior Solutions Manager here at Outsource Strategies International. Today we'll be discussing medical billing and coding trends that practices can't ignore in 2021.

00:15 Importance of Following Billing and Coding Trends

The healthcare sector has been reluctant to embrace technology, one of the main concerns being patient safety. Medical billing and coding rules and the codes themselves are changed periodically, and new codes are introduced from time to time. To improve any facility’s bottom-line, physicians as well as their billing staff must be up to date with the current trends. Adopting these changes can also benefit each practice – get reimbursement on time, avoid claim denials, and improve revenue.

Changes in Medicare and Medicaid policies, complicated and rigid coding rules, changing technology options and such challenges make the billing process complicated for practices each year.

00:53 2021 Medical Billing and Coding Trends for Practices

Here are the top four trends medical practices need to consider in 2021.

Medical Billing Outsourcing Market to Grow

The healthcare system is currently witnessing an increase in the use of outsourced medical billing services by hospitals and physicians mainly due to complex ICD-10 coding systems, increasing healthcare costs, and a federal mandate to implement electronic medical records (EMR) to maintain reimbursement levels. Diverse reports were published highlighting the future growth in this global market. According to a report from Grand View Research, Inc, the global medical billing outsourcing market size is projected to reach 23.1 billion dollars by 2027. Consolidation of large healthcare practices is one of the major factors that drives this market growth.

Automation in Medical Billing

Automation in medical billing practice refers to tasks such as claims submission, and other important aspects of the process being handled by cloud-based software. Artificial intelligence (AI) reduces the risk of any errors in the medical claims and reduced payment delays and denials.

With properly implemented automation, your front office staff can find more time for patient engagement and patient responsibility, which improves patient satisfaction as well. Automated processes can emphasize patient interaction with healthcare professionals. However, practices need to be proficient in using AI technologies to implement this sort of billing system.

Awareness of Coding Updates

Agencies like CMS and AMA often announce important updates with in CPT or ICD-10 codes. For instance, the American Medical Association (AMA) has recently announced new CPT codes for SARS-CoV-2 vaccine. Those six Category I codes for documentation of the COVID-19 vaccine are listed in the article attached.

Focus on Accounts Receivable Collection

Establishing an effective accounts receivable (AR) management strategy plays a key role in running a successful medical practice. AR refers to any amounts due from patients or insurers. Neglecting this section would lead to poor cash flow and lost revenue. To clear accounts receivable, it is important to check monthly A/R reports, review codes submitted to payers, perform internal auditing and appeal on-time for any denied claims. Reliable medical billing companies implement customized A/R strategies to improve the cash flow of any practice they work with.

To overcome the current healthcare billing complexities and to streamline the revenue cycle management of practices in this New Year, it is important to be up-to-date with such trends.

I hope this helps, but always remember that documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed. Thank you for joining me and stay tuned for my next podcast!