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In the U.S., medical coding is the creation of medical codes that identify with specific diagnosis and services in the healthcare industry. These codes are identified through medical documentation. 7 Essential Principles For Growing Your Medical Coding & Billing Business in 2018 These codes are used to determine the details of billing, and the efficient use of coding leads to accurate billing. This finally results in the determination of insurance claims. A significant component, therefore of the medical coding and billing business is the efficiency of the medical claims billing service.

According to the Medical Billing Guide, “Medical records specialist earn a median pay of $35,900 per year, which isn’t bad for a profession that requires little education or training.”

Irrelevant to the industry, there are some business fundamentals that every entrepreneur takes into account. However, market research indicates factors that are specific to each industry. The medical billing and coding industry is one that comes with its specifications. As the healthcare industry is predicted to double over the next ten years, medical billing and coding businesses are poised for growth, while being relatively recession proof.

Medical codes are applied using CPT®, ICD-10-CM, and HCPCS Level II classification systems. Medical coders, therefore, need to be proficient in the application of these codes. The medical billing business, subsequently, pursues the claims determined through these codes for reimbursements from health insurance companies to the healthcare company.

A medical billing and coding process, therefore, offers end-to-end billing and management solutions to ensure that the healthcare provider gets paid to their maximum entitlement. The ultimate goal is to minimize insurance claims denials.

Below are seven principles that can aid towards powering your medical billing and coding business to transform into an industry leader.

Computer Assisted Coding (CAC) is Your Best Friend

Whatever the state of the economy, citizens will always need medical care. However, the affordability is subjective. To avoid any dependence, medical billing services need to be increasingly efficient in their execution. The most error-free mechanism towards achieving this end is deploying the relevant technology, i.e., CAC. With the ICD 10 transition and the introduction of a host of new codes, medical coders need assistance in ensuring error-free coding. There are ever-evolving technologies of artificial intelligence and data mining that go a long way in improving billing and management solutions, by predicting the possibility of insurance claims being denied, flagging faulty coding, and automating the coding process. Ultimately, CAC maximizes the amount that can be claimed by the healthcare provider, which is the key to retaining customers.

The use of CAC further reduces the amount of paperwork involved in the medical billing process.

Technology has shifted the paradigm to automated coding, which limits the amount of manual execution and thereby minimizes the possibility of human error.

According to a report available through Research and Markets, “the global market for computer-assisted coding software is projected to reach $4.75 billion by 2022”. However, technology is not at a point where it can replace human coders. According to a recent report by Herzing University, “The U.S Department of Labor predicts that employment for health information technicians will grow by as much as 15 percent through 2024-much faster than average for most occupations.” This growth is significant of the ever-increasing need for innovative technology to be merged with the skill of medical coders and billers that will solidify the accuracy of medical billing claims services.

Further, according to the Capterra Medical Software blog, A Cleveland Clinic study found that CAC had a lower precision rate when used without the assistance of a credentialed coder. “It cannot be overemphasized that the use of computer-assisted coding alone does not replace certified coders. The software is limited and does not have the ability to apply guidelines or make decisions about code application and the circumstances of each admission. It does not have the ability to ‘choose’ a principal diagnosis or a principal procedure, and in many cases, does not have the ability to build ICD-10-PCS procedure codes.”

In a nutshell, CAC will assist your business through:

7 Essential Principles For Growing Your Medical Coding & Billing Business in 2018

Automated translation of clinical documents
Suggested codes for application
Flagged errors
Automated reviews for coders
Automated billing suggestions
Fewer errors for swift claim acceptance
Embrace Blockchain Technology
To put it simply, blockchain technology is an only once-written record of digital scenarios that can be shared between different entities for viewing only purposes. Within the healthcare industry, there is no doubt about the high level of interconnectedness between the healthcare providers, medical billing and coding companies and insurance claims companies. This is where the blockchain technology plays a crucial role.