The relationship between medical coding and patient care may not initially appear connected, and they may even seem like complete opposites. While medical coding focuses on billing and revenue, patient care revolves around providing care to individuals. An from leading E-magazine’s recent article emphasized this distinction, asserting that prioritizing care is essential over coding. However, what if one aspect is not more significant than the other? What if both caring and coding can collaborate synergistically? This is precisely what occurs when medical coding incorporates automation.
The introduction of medical coding automation brings about several benefits. It optimizes the coding process by reducing costs, enhancing accuracy, and expediting the revenue cycle. Moreover, it also positively impacts patient care. Here’s an explanation of how this synergy is achieved.
Maximizing Margins and Enhancing Patient Care: Medical Coding Automation Delivers Both
The significance of medical coding automation in improving both margins and patient care is often overlooked by many practice managers. However, without automation, achieving these dual benefits becomes considerably more challenging.
To begin with, let’s discuss how medical coding automation enhances margins in three key ways:
Enhanced Accuracy:
Medical coding automation ensures a high level of accuracy, resulting in a reduction of denied claims, rework, and partial reimbursements.
Accelerated Revenue Cycle:
Automation expedites the coding process, providing coding results within hours or minutes instead of days or weeks. This swift turnaround accelerates the revenue cycle, leading to improved cash flow, fewer accounts receivable days, and reduced pressure on the practice.
Reduced Costs:
While many practices opt to outsource coding to offshore companies as a cost-cutting measure, medical coding automation often proves to be equally or less expensive. Combining the cost-effectiveness of automation with its speed and accuracy translates into significant savings for the practice.
Now, let’s challenge the traditional perception of medical coding and consider how automation contributes to patient care. While it may initially seem unusual to associate coding automation with patient care, it is indeed a reality. When medical coding is completed faster and with greater precision, it frees up physicians’ time and lightens their workload. This additional time can then be devoted to improving the well-being of patients. We will delve deeper into this concept shortly, but first, let’s explore how automation addresses the limitations of human coding.
How Doctors, Human Coders, and Patients Benefits From Medical Coding Automation
For decades, human coding has been the conventional approach in the medical field. However, it directly impacts both doctors and patients in terms of quality of care. From the perspective of doctors, human coding adds to their administrative burden. Physicians play a vital role in the coding process as their documentation of patient-doctor interactions forms the foundation for assigning appropriate medical codes.
Medical coding automation comes to their aid by improving the documentation process, identifying missing or incomplete information, and highlighting areas that require further details or clarification. Medical coding automation not only assists doctors in efficiently documenting patient encounters but also enhances the quality and accuracy of medical codes. This relieves doctors from the need to spend time reviewing and correcting coding errors, as well as handling potential appeals and resubmissions due to denied claims. Instead, doctors can devote that time to direct patient care, thereby improving the overall quality of care provided.
While doctors handle a portion of the coding process, the bulk of the responsibility lies with medical coding professionals. However, due to a shortage of human coders, patient billing can become slow, ultimately affecting the patient experience. Delayed billing creates confusion and financial strain for patients who may not have accurately budgeted for the delayed bill or may even forget about it entirely. Such incidents can lead to lower satisfaction with the practice. In contrast, medical coding automation speeds up the process, minimizing billing delays, and ensuring that patients are not caught off guard by forgotten bills.
Benefits of Automated Medical Coding
Now that you have gained insight into the limitations of human coding, let’s explore how automation significantly improves the process:
Higher Physician Job Satisfaction and Retention:
Doctors pursue their careers to make a difference in patients’ lives, rather than getting burdened with coding and administrative tasks. Automated medical coding frees up physicians’ time, allowing them to focus on patient care. This leads to increased job satisfaction, reduced stress, and improved engagement with patients. Consequently, physician retention naturally improves.
Improved Revenue Capture:
Automated medical coding, as mentioned earlier, boasts high accuracy. It identifies procedures that may be overlooked by doctors or human coders during review. It also enables precise determination of acuity levels, resulting in more accurate diagnoses and appropriate reimbursement.
Easier Practice Management with Instant Guideline Updates:
Coding guidelines undergo regular changes, usually on an annual basis. This necessitates implementation of updates and retraining of coding teams for providers. Constant changes slow down human coders and introduce the risk of inaccuracies. However, with autonomous coding, the system can be configured to reflect guideline changes, enabling near-instant updates. For instance, at the beginning of 2023, emergency medicine faced new evaluation and management coding guidelines. While many providers are still adapting and retraining their teams, organizations with automation in place swiftly adjusted to the new rules.
By embracing medical coding automation, healthcare practices can enhance physician satisfaction, optimize revenue capture, and streamline practice management in response to evolving coding guidelines.
How These Benefits Translate To Improved Patient Care
The advantages provided by medical coding automation not only enhance a practice’s overall efficiency but also yield significant benefits in patient care.
More Engaged and Available Physicians = Higher Quality of Care:
Medical coding automation reduces administrative work and alleviates stress for physicians, resulting in healthier and happier doctors who can provide better care to their patients. This is particularly important considering the rising prevalence of burnout in the medical industry. Research from the Mayo Clinic reveals that physicians experiencing burnout are more than twice as likely to make perceived medical mistakes. In other words, well-rested and satisfied doctors are more alert, clear-headed, and capable of delivering accurate diagnoses and appropriate treatments.
Faster Revenue Cycle = More Time Dedicated To Patients:
Automated medical coding not only expedites the billing process for patients but also minimizes administrative issues, optimizing medical billing as a whole. This benefits both doctors and the practice by freeing up time and resources that can be dedicated to patient care. Consequently, patients experience quicker diagnosis and reduced wait times.
Fewer Coding Mistakes = Fewer Medical Errors, Happier Patients:
Coding errors have broader implications beyond delays and increased costs—they can directly impact patient well-being. From a financial perspective, patients may receive bills for treatments they didn’t receive or that were unnecessary. From a healthcare standpoint, the omission of a 2-digit modifier could lead to a patient undergoing imaging on the wrong area of the body, for instance. Such errors can have negative consequences for patients and harm the reputation of the practice. However, with coding automation, the occurrence of these mistakes is minimized, resulting in a happier patient population.
In summary, medical coding automation not only streamlines operations and financial aspects of a practice but also contributes to improved patient care by fostering physician engagement, reducing errors, and optimizing the allocation of resources towards patient well-being.
Getting Started: How Practices Implement Medical Coding Automation
If you’re considering implementing medical coding automation at your practice, you might be wondering about the process. While the technology is based on artificial intelligence (AI), its implementation is similar to other IT projects. Here are some steps to get started:
Make A Plan: Begin by defining your goals for implementing medical coding automation. Consider what you want to achieve, such as improved patient and physician satisfaction or cost reduction. Determine whether you want the technology to be used by coders and doctors only or throughout your entire practice. Having a clear plan will help you stay focused and accomplish your objectives.
Involve Your Entire Practice: Implementing new technology can create friction, especially if it comes as a surprise to your employees. To minimize resistance and ensure a smooth transition, involve all stakeholders from the beginning. Engage in discussions with doctors, coders, management, IT staff, and others who will be impacted by the technology. By gaining their support and input, the implementation process will be much smoother.
Create A Test Project: Transitioning to new technology often involves some initial challenges. Compatibility, configuration, and integration issues may arise. To mitigate these potential problems, start with a test project that involves a small portion of your practice. This allows you to identify and address issues early on, ensuring a smoother scaling-up process when you expand the technology throughout your practice.
Hire An Experienced Vendor: Given that AI is cutting-edge technology, it is advisable not to tackle its implementation alone, even if you have an IT department. Engage the services of a vendor that specializes in medical coding automation. They can assist you with deployment, ensure a smooth process, and provide guidance tailored to your specific needs. A vendor can also address your questions, customize the coding technology, and help maximize the return on investment for your practice. Involving a vendor from the early stages will facilitate training, support, and overall success.
By implementing medical coding automation, you can improve patient care and enhance your entire practice. The traditional dilemma of prioritizing coding or patient care is no longer necessary. Automation improves margins while playing a pivotal role in enhancing patient care. It adds value to your practice, making it more efficient, effective, and appealing to patients.
