The Impact of Modern Technology on Medical Billing and Coding

The Impact of Modern Technology on Medical Billing and Coding


The Impact of Modern Technology on Medical Billing and Coding

Technology has played a crucial part in the development of the healthcare industry. Traditionally diagnosing and treatment of patients was quite complicated, and it took considerable effort and resources. The rapid advancement in technology has allowed the development of high-tech medical equipment, cost-effective medicines, and innovative procedures that have streamlined every medical function and improved healthcare service quality.

The Present Outlook of Healthcare Industry:

The healthcare system must constantly evolve and match technology's speed to efficiently address the patients’ needs and stay competitive. In recent times, the healthcare system has to face numerous challenges such as

  • Rising healthcare costs
  • Lack of patient-specific treatment
  • Inefficient processes
  • An increasing number of patients suffering from both acute and chronic ailments

The healthcare systems' capacity and capability are heavily tested with the Coronavirus pandemic, and many of the health centers are overburdened and understaffed to cope with the growing number of patients. The changing trends in the medical field are directly affecting both the patients and healthcare providers. From a patient’s point of view, healthcare revolves around the

  • Insurance coverage which means if the patient can afford the costs of treating either acute or chronic disease
  • The closest availability of healthcare facilities and services
  • The timely diagnosis, treatment and prevention of disease

The solution to nearly all the healthcare industry's challenges lies in adopting and implementing technological solutions, which include modern equipment and digital transformation with innovative software and systems.

The Role of Digital Technology in Healthcare:

Digital technology has significantly helped in wide healthcare functions such as data collections, research, medical billing and coding, remote monitoring, compliance with health regulations, and timely diagnosis and treatment. The biggest advantage of using technology is streamlining each function, saving time, reducing mechanical paperwork, and removing any error that can affect the entire medical process.

A medical practice such as a hospital or a physician’s clinic is responsible for delivering appropriate healthcare services to patients and managing their finances to pay the healthcare providers' salaries and control the cost of treatment, which includes procedural treatment and supplies and payment of overheads.

The revenue cycle management (RCM) is a key process of every medical practice as it ensures that the patients are charged correctly, and more importantly, the healthcare providers such as doctors, surgeons, nurses, therapists, lab technicians, and social workers are paid correctly for rendering their expert services.

The revenue cycle process starts with patient registration and ends when the healthcare provider receives full payment for providing the medical services. Medical billing and medical coding are both different processes but interlinked and crucial for a smooth medical revenue cycle management.

Medical Coding

The process of taking a patient’s diagnostic and treatment notes and converting them into correct alphanumeric codes for accurate billing and record-keeping is called ‘medical coding.’ The different types of codes include Current Procedural Codes (CPT) codes, International Classification of Disease (ICT) codes, and Healthcare Common Procedure Coding System (HCPCS) codes.

Medical Billing

Once the coding is completed, the process of generating correct patient claims or invoices based on coding and sending it to insurance companies for payments is called ‘medical billing.’ The insurance companies will approve or deny payments based on codes. Any payment for medical service not covered in the insurance plan will be sent to the patient. The billing process begins as soon as the patient sets up an appointment with a medical practice.

The Purpose of Using Medical Billing and Coding Software:

Until the 2000s, most of the medical coding and billing was done manually, and it meant tremendous amount of paperwork first for coding and then billing the claim. The paperwork increased if the insurance company denied payment due to coding or billing error.

Medical billing is a meticulous task and requires valuable time, and in times of global pandemic, it can be difficult for medical practices to train and recruit professionals who can handle both the coding and billing tasks efficiently and claims not correctly processed can directly impact the revenue cycle.

The hospital billing software solutions are redefining the entire claim processing and payment collection task. The best advantage is streamlining the process and reducing errors, and the medical staff can focus on managing better care for the patients.

Electronic Health Records (EHR) have also been quite valuable in the healthcare industry, especially for medical practitioners. EHR help to maintain a clear and complete patient record as compared to paperwork.

PETTIGREW is an accredited company offering complete, user-friendly medical billing and coding solutions to various healthcare organizations. The company was founded in 1989 and quickly became one of the prominent billing, coding and staffing solutions on a global scale. PETTIGREW’s clients include hospital systems, healthcare consulting firms, and physician clinics.

PETTIGREW has a team of qualified and skilled professionals taking full advantage of technological advancement to design and develop the best healthcare industry solutions. The innovative tools are best to improve clinical documentation, provide a centralized platform for patient records, and even assist the medical practice with audits. The numerous value-added features provided by PETTIGREW medical business services include

  • Seamlessly integrating the medical practice’s RCM with billing and coding solutions for timely payment collections
  • Remote Coding Services
  • Auditing and Compliance services
  • Payer Connect to engage with individual payers and work with each payer’s specific policies for full payment in less time.

Traditionally medical professionals had to manually enter codes into the dedicated computerized systems to make a patient medical record into the database. The medical codes are complicated due to the numerous types of acute and chronic diseases and depend on diagnosis and treatment for a specific patient.

The medical codes are changing with time, and the growing changes within the healthcare industry compel medical practices to update the changes in codes. It can be challenging for medical billing and coding specialist to get hold of all the changes, but a proper software can efficiently update the codes and without any errors. The software solutions can also easily update the patient’s medical records according to updated medical codes.

The development of artificial intelligence and automation has helped significantly to increase medical billing and coding speed. In these Covid-19 times, due to lockdown and social distancing now coders can easily work remotely and from home rather than being on-site. Modern computers and even smartphones have sophisticated applications primarily designed to help in medical coding.

The Advantages of Billing and Coding Software Solutions:

Nearly three decades ago, healthcare information was based solely on paperwork, which was a tedious and time-consuming task. However, the implementation of medical billing and coding software is reshaping and improving health information management. As the baby boomer population is aging, the need for particular healthcare services is expected to increase, and so will the need for medical practitioners.

The modern medical coders use software to transcribe information of a patient from symptoms to diagnosis to treatment into an electronic code, which is easily stored in the patient’s database that is then managed by the medical practice. The code or information is utilized to form a medical bill and then sent to insurance companies to reimburse healthcare providers.

The modern medical coding software is referred to as ‘encoder’ that makes the entire coding process easy and simple, with just a few clicks. The hundreds of different codes, which can even be tough for a professional to memorize, can easily be selected from the software, and the codes are also automatically updated.

The encoders help to identify and select appropriate code for a particular diagnosis or procedure, but professional coders are also needed to use their knowledge and skill to ensure that proper medical claim is processed. The advantages of using sophisticated coding and billing solutions are

  • Providing a suitable platform for medical practices to record patient medical history, diagnosis, and treatment
  • Quickly verifying the insurance eligibility and status
  • Considerably improving the billing and coding processes and removing any errors
  • Ensuring that accurate claim is sent to insurance companies with no chance of any rejection
  • Facilitating timely reimbursement to the healthcare provider for their services
  • Analytical tools to help in fast reporting and scheduling.

The medical claims are processed faster once the benchmark of collections are set, and medical staff can also devote their time to caring for the patients instead of worrying about filling all the mundane paperwork.