Artificial Intelligence (AI) has done a tremendous job in revolutionizing technology, especially in the medical field. An example of an area that has significantly benefited is in medical billing and coding. It is common knowledge that medical billing and coding play a significant role in the provision of healthcare. The coding and billing have a vital role in translating patient data into standard codes which are subsequently used by third-party stakeholders including Medicare and other insurance companies. As a result, coding accuracy becomes an essential tenet that must be met by the hospitals. The Center for Medicare & Medicaid Services (CMS) reported that errors resulting in the improper payments amounted to $36.21 billion. Therefore, companies are increasingly applying AI applications as a viable way of improving medical billing and coding. As a student in healthcare, the advent of AI means that health care will become more accessible to people due to the efficiency it will create in providing the relevant data to the insurance companies. The companies will, in turn, act swiftly to enhance reimbursement or the provision of cover where necessary.
Discussion
The AI applications used in billing and coding primarily fall under the Computer Assisted Coding category. Companies are utilizing Natural Language Processing (NLP) and machine learning to identify and recognize data automatically from the medical files and documents. Research has shown that proper implementation of the AI can boost the efficiency of billing times time more than what many companies currently use. Furthermore, with a slow physical workforce, AI aims at enhancing efficiency and effectiveness in the billing and coding process. When done manually, the medical coding job can be tiresome and cumbersome and will require a higher number of workers. The recent massive inaccuracies witnessed in the coding field are attributable to the lack of AI in the field.
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Therefore, the AI applications have a critical role in improving accuracy in the entire process. The emerging technology primarily relies on Computer Assisted Coding (CAC) where the machines engage in the automatic extraction of data from the patient's documents and feed them into the system. The two important areas that the company will benefit include saving time and reducing the human errors. Other than processing the codes efficiently, it will also have the capacity to manage large volumes of data with an increased level of precision. The application can also work to detect human errors and recommend ways in which it can be rectified. As a professional in this field, it would be my moral interest to ensure that efficiency in medical billing occurs so that funds are not misappropriated. Moreover, since the insurance companies will receive the health information timely, health accessibility will not be impeded.
However, there remain viable fears that the use of the AI applications would result in job loss to many people. There is a prospect that the AI will perform a job that would otherwise require tens of people to do. Therefore, unemployment and retrenchment loom in the wake of this significant invention. However, I would suggest the policymakers incorporate the AIs as human helps to ensure that each one serves as a backup for the other. The complementarity between the two sides will further increase accuracy and efficiency.
Summary
AI applications in billing and coding seek to improve accuracy and efficiency. The field has experienced massive errors and misappropriation of funds which has derailed payments done by insurance companies. Therefore, the use of AI will ensure that health records of patients are automatically fed into the system from the patient’s documents. It will further have a correction mechanism to countercheck any human error.
Reference
How Artificial Intelligence is Rewriting the Medical Coding Automation. (2018). Retrieved from: https://www.osplabs.com/insights/how-to-boost-medical-billing-business-using-artificial-intelligence/
