Last year saw the perfect storm of challenges hit the healthcare industry. The lingering effects of the COVID pandemic, exacerbated by unprecedented and rising inflation, caused a tidal wave of ill effects—staff shortages, rising labor costs, and pressure from payers, to name a few. As a healthcare executive, you’re left to deal with the repercussions.
According to Michael Meucci, CEO of Arcadia, “Many of the pressures that challenge health systems’ budgets and margins will continue into 2023 and beyond.” You read that quote correctly. Many of the problems that plagued 2022 aren’t looking to improve. But “improve” is exactly what you must do: deliver better margins this year. You feel the pressure. But how can you possibly reduce costs and increase revenue in such an uncertain healthcare landscape?
Medical coding automation may be your secret weapon to reach your revenue and cost goals. While medical coding is an often overlooked part of the revenue cycle, adding automation to the process can reduce claims denials and A/R days, speed up the revenue cycle, and improve your cash flow, among other benefits. How? Before we get to that, it’s important to understand what medical coding automation is.
What Is Medical Coding Automation?
As you probably know, medical coders are the people responsible for translating doctor’s services into the codes that determine what providers get paid. The problem is, the medical coding industry has suffered a chronic shortage for around a decade, if not longer.
According to a CNBC report, the industry had a constant 20-30% shortage of coders back in 2014. And the situation hasn’t improved. The medical coding market is projected to grow at a compound annual growth rate of 8% through 2030, increasing the need for medical coders.
The lack of qualified coding experts has led to rising costs and delays in the claims process. In the past, the only ways to solve this problem were to attract more human coders to the industry or to improve the efficiency of current coders. This is where medical coding automation comes in.
The technology harnesses deep learning, natural language processing, and other AI techniques to automatically code clinical encounters without need for human intervention. In other words, it dramatically speeds up the medical coding process and reduces the need for manual effort. Instead, automation tools handle some portion of the coding volume entirely.
How Automation Reduces Costs and Gets You Paid Faster
Many healthcare organizations attempt to lower medical coding costs by outsourcing the process offshore. While doing this sounds good in theory, there are hidden costs. Not only are offshore coders typically less productive than their US counterparts, but according to the Healthcare Financial Management Association, they have approximately 10 more denied claims per week on inpatient-and-same-day surgery encounters.
On the other hand, medical coding automation is often priced similarly to or cheaper than offshore coding and is highly accurate—reducing claims denials and limiting costly and time-consuming rework. The technology also accelerates the revenue cycle. Complete coding results can be delivered in as little as 30 minutes. This translates to shorter collection times and fewer A/R days, resulting in better cash flow and less pressure on your organization.
How Automation Increases Revenue via Improved Accuracy
Inaccurate medical coding causes a host of problems. Denied or partially paid reimbursements eat into your bottom line. And delays because of medical coding errors can create a deluge of paperwork for your organization to deal with, causing stress and extra work for your staff. Medical coding automation prevents these problems.
When sourced from a high-quality partner, autonomous medical coding technology ensures all procedures are properly identified and billed for at the appropriate time. You may even see your relative value units (RVUs) increase. The result is profound: you transform the medical coding process from a cost center to a margin-increasing engine.
You Can Reach Your 2023 Revenue and Cost Goals
Undoubtedly, healthcare executives are under a lot of stress right now. In this precarious environment rampant with rising costs, staff shortages, and little room for error, you need to find creative ways to lower costs and increase revenue. Medical coding automation could be the answer.
Whether you’re on the hook to improve revenue capture, get out from under coding backlogs, or get cash in hand faster, AI-powered technology can help. Using it is like having a highly experienced and efficient coder on your team that is available 24/7. It doesn’t take sick days, doesn’t need a vacation, and is there for you when you need it.
A dependable tool like medical coding automation gives you room to breathe. It may be just what you need to hit your financial goals in 2023.
Andrew Lockhart is Co-founder and CEO of Fathom, the leader in autonomous medical coding. Fathom applies cutting-edge deep learning and natural language processing (NLP) to produce complete coding results for patient encounters with zero human intervention. We deliver the highest automation rates and the broadest specialty coverage for leading health systems, physician groups, and revenue cycle management companies.