EHR and Health IT Consulting
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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Medical Billing and Coding Trends for 2018

Medical Billing and Coding Trends for 2018 | EHR and Health IT Consulting | Scoop.it

According to the New York Times, disease-classification systems originated in 17th-century London to help doctors prevent the bubonic plague from spreading to populations that didn’t speak English.

 

French physician and statistician Jacques Bertillon (the 1890s) introduced the first medical coding system when he developed the Bertillon Classification of Causes of Death. In the 20th century, the codes encompassed not only causes of death but also the incidence of diseases.

 

These days, medical coding translates the content of a patient’s health records into a universal standard medical code so it can be billed properly. Let’s take a closer look at the landscape to see how things stand, and identify the medical billing and coding trends you should look for in 2018.

 

The medical billing and coding landscape

 

Between 2015 and 2020, Deloitte predicts worldwide spending on health care will increase anywhere from 2.4 to 7.5%. Despite this extra spending, many healthcare delivery organizations are facing increased operational costs, which are eating into their returns.

 

One source of increased operational costs is the ever-expanding complexity of medical billing. The same Times piece cites in-office earwax removal and vaccinations as examples; there exist unique codes for the method used as well as each injection. On top of that, not every payer uses the same coding system.

 

Administrative costs account for a full quarter of U.S. hospital spending; for comparison, those costs sit at 16% and 12% in England and Canada, respectively.

 

While medical billing and coding are ever-changing, there is the general movement toward efficiency. Here are three medical billing and coding trends you should be watching in the coming year; they’ll only get more important as 2018 gets underway

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Three trends to look for in 2018

 

1. Computer Assisted Coding (CAC)

 

  • Uses natural language processing (NLP) to read and interpret text-based clinical documentation from patient charts.
  • Identifies potentially relevant ICD-10-CM diagnoses, ICD-10-PCS and CPT procedures, and present on admission (POA) indicators to provide suggested codes and corresponding documentation for coders or CDI specialists to review and approve.

 

CAC software is proliferating, particularly for coding inpatient claims. 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.

 

According to CareCloud, coding specialists are afraid that the CAC built into EHRs could replace their jobs within a decade. This concern, however, is likely overblown. CAC is a huge help to human coders. According to one study, CAC increased coder productivity by over 20% and reduced coding time by 22% relative to their peers who didn’t use CAC, all without reducing accuracy.

 

2. EHR alignment


Poor record keeping—from not capturing the chart data you need to code correctly to capturing the data but making it hard for a coder to find later—can lead to a variety of problems for reimbursement. Already, most providers spend too much time searching for the right diagnostic codes for their patients rather than looking at and listening to them.

 

If your EHR and medical billing software are integrated, especially if your medical billing offers CAC, the process can go much faster. For example, your software can offer coding suggestions at the point of documentation, making codes more accurate from the get-go.

 

When your EHR has integrated CAC, it can automatically populate patient demographic data into a bill instead of wasting time by requiring staff to re-enter it and introducing the opportunity for errors. Fewer errors increase your first-pass claim acceptance rate, can improve data abstraction, and offer more robust reporting than standalone EHR and billing and coding software.

 

This reporting can include a robust set of financial data, such as units billed per visit, days sales outstanding (DSO) to accounts receivable, net revenue per visit (NRV), staff productivity, referral numbers, appointment cancels, and no-shows.

 

3. Blockchain
In 2016 ONC called for white papers on how the blockchain can improve healthcare. Researchers submitted more than 70 papers, and ONC awarded 15 papers covering everything from precision medicine clinical trials and research to a decentralized blockchain-based record management prototype for EHRs.

 

“Blockchain is booming in clinical trials right now; it is a big favorite of the pharmaceutical sector,” Maria Palombini, director of emerging communities and initiatives development at the IEEE Standards Association, said. Palombini predicts that blockchain has an especially intriguing promise in EHRs.

 

In early 2017. EHR Intelligence’s Kate Monica wrote: “Blockchain is becoming increasingly common as a way to improve the standardization and security of health data.”

 

In September, HealthcareITNews published “Why blockchain could transform the very nature of EHRs.” And Bruce Broussard, CEO of Humana, described blockchain as the next big healthcare technology innovation.

 

There are three primary reasons EHRs should consider adopting blockchain data storage:

 

  • It can offer better privacy protections
  • It can make information exchange easier and more efficient
  • It can increase patient control over their data

 

With blockchain, it could be as simple as a patient giving their doctor a token to access their records. “Using blockchain technology to reconfigure EHRs makes sense,” Elizabeth G. Litten, partner and HIPAA privacy and security officer at Fox Rothschild, recently wrote.

 

Dave Watson, a chief operating officer at SSI Group (an RCM and analytics company), sees tremendous potential for the blockchain to improve revenue cycle management and claims processing.

 

By recording tests, results, medical billing, and payments in an immutable ledger, the blockchain could reduce fraud and even save money by decreasing the time and labor currently used to track that information through various systems.

 

On Medium, strategy, design, and development consultancy Sidebench wrote that the three areas where the blockchain could impact healthcare with the clearest path forward to providing significant ROI through cost savings are developing better health exchanges, protecting patients and practitioners through supply chain accountability, and reducing fraud in billing and claims.

 

Palombini’s “Holy Grail” is when patients own and control their own complete health histories, from the hospital, stays to outpatient visits to data from wearables. A blockchain is a tool that could help get us there. But it’s not the only way.

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

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Become an EHR Super User

Become an EHR Super User | EHR and Health IT Consulting | Scoop.it

When I visit clinics to help them optimize EHR use, there is a clear difference between the super users and other users. While the super users may still have complaints about the system, they are nowhere near as frustrated as the other users. This is because they have invested the time in understanding how to leverage the EHR to significantly speed up their everyday workflow.

 

Most EHRs have built-in "accelerators," tools and shortcuts similar to what you find in Microsoft Word or Excel, for greater efficiency. The problem is most physicians don't bother to learn them because they've either exhausted many systems in their career or there is not ample time in the day to do anything other than "survive" in the clinic. But taking the time to learn to use something you use for hours a day every day pays off, and investing as little as an hour each week learning to better use your EHR has been shown to increase physician satisfaction.

 

Three tips to get you started


1. Make sure you understand and spend some time loading your system's "macros." You want to make checking off boxes or typing a rare, unique action, not a routine one. One rule of thinking is that if you are doing the same thing the third time, you should spend a moment to save it, memorize it, macro it or whatever your system calls it.

 

2. Get a good tool for finding diagnosis codes. I recommend Problem IT Plus. Try it and you'll thank me if you are doing this now without it.


3. Make sure you understand how your system enables team-based care. Allowing everyone to practice at the top of their license and contribute to the delivery of care is crucial. Empower the care team to create notes and use automated tasking and messaging within the EHR whenever possible.


It is an exciting time for healthcare IT: leverage tools such as the EHR and allows them to help you refocus on the business of medicine instead of the business of administration. It takes an extra hour or so a month, but allows you to focus on the three things that matter most: your patients, your practice, and yourself.

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

more...
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