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Medical Billing and Coding Plus Artificial Intelligence

Outside the health care industry, there aren’t many who understand medical billing and coding. With more than 70 thousand billable codes in the latest ICD-10 (International Classification of Diseases, Tenth Revision) update, this complex system will need the watchful eye of computers managed by highly trained medical billing and coding professionals.

Starting with IBM’s Watson, artificial intelligence has begun helping medical professionals provide better health care to patients. Now artificial intelligence is revolutionizing the way medical billing and coding is done. To take full advantage of AI’s numerous benefits, it’s important for medical coders to understand artificial intelligence’s place in the profession.

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Artificial intelligence has the ability to identify trends, monitor for errors quickly and efficiently, and stop fraud from happening in medical billing and coding. Artificial intelligence can identify duplicate coding, trends of upcoding, and common errors that medical billing and coding professionals make.

What Is Artificial Intelligence?

Artificial intelligence mimics human cognitive functions and can perform many of the jobs traditionally done by educated professionals. While images of robots may come to mind, the reality is that AI is much more helpful than robots from the future. Although some artificial intelligence seems to learn as it goes along, this process is typically still controlled by humans.

The main goal of artificial intelligence—especially in the medical billing and coding world—is to automate certain processes. Where artificial intelligence is getting the most use in medical billing and coding is in the performance of audits and in spotting errors. Even the best medical coder can make a mistake, but instead of this mistake slipping through the cracks or taking hours to fix, artificial intelligence can quickly recognize and correct it.

Watson and the Medical Industry

IBM created Watson to revolutionize the way businesses use artificial intelligence and algorithms to increase productivity, provide answers that humans can understand, manage data, and provide outcomes from that data.

Watson was put to the test in the medical industry in an effort to be a support system to clinical decision making. A physician will pose a set of symptoms, and Watson will review its library of medical information to mine patient data and form an hypothesis.

Watson can access electronic medical records and research material, clinical studies, and journal articles to test medical hypotheses. Watson is still utilized in the medical industry and now helps businesses in education, financial services, and many other industries.

Benefits of Artificial Intelligence in Medical Billing and Coding

While utilizing artificial intelligence to catch billing and coding errors would be enough to justify its use, there are a variety of other benefits that come along with the technology.

One of the most obvious is artificial intelligence’s potential for identifying false claims or suspect charges. With health care fraud costing Americans anywhere between $68 billion and $230 billion yearly, having algorithms in place that can immediately recognize suspicious activity is vital.

Additionally, artificial intelligence is capable of identifying information that’s not explicitly stated in physician documentation. Even with all of the benefits of accurate billing and coding—including higher reimbursement rates and quality scores—doctors still often fail to have a complete understanding of medical billing and coding.

Fortunately, artificial intelligence can use natural language software to apply appropriate codes even when a physician fails to document them fully.

The Future of Artificial Intelligence in Medical Billing and Coding

Medical billing and coding has a strong history in identifying root causes of injury and disease. This includes everything from identifying the dangers behind texting while driving to the identification of infectious disease trends.

Medical coders have literally saved lives and provided information that helped guide safer driving laws. Artificial Intelligence will certainly assist in similar endeavors in the future.

Professionals are even beginning to focus on how medical billing and coding can recognize child abuse when not specifically identified by physicians. This is only one of many emerging trends in the industry, and as more knowledge is garnered, artificial intelligence can be updated to spot these nuances even if coders fail to.

Fortunately, this doesn’t mean that medical billing and coding will one day be taken over by computers. The fact remains that humans are necessary to decipher trends even if computers do identify them, and some trends could go completely unnoticed without human input.

Ability to Adjust Is Essential

Although artificial intelligence is a constantly evolving technology, the implications of its use in medical billing and coding are already overtly apparent. From fixing common errors to identifying epidemiological trends, artificial intelligence is continuously accelerating knowledge in the medical world. Since demand for medical coders is currently exploding, health care administrators will undoubtedly seek professionals who can evolve with this technology.

Are you ready for a rewarding career as a medical billing and coding specialist? The Medical Billing Specialist program at Hunter Business School on Long Island prepares billing and coding students to obtain entry-level employment specializing in medically related billing and coding in physicians’ offices, clinics, medical insurance companies, and hospitals. The Medical Billing Specialist program also offers students a diploma in three months of evening classes.

Contact us today to find out more about how to become a medical billing specialist on Long Island.