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Dan Murdoch

September 7, 2023
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Medical Billing & Coding Trends You Should Know About

Medical Billing & Coding Trends You Should Know About

The healthcare landscape is continuously evolving, influenced by technology, regulatory changes, and patient needs. Medical billing and coding are critical elements of this ecosystem, ensuring healthcare providers are reimbursed for their services and patients understand their financial responsibilities. Here are some of the most important trends and statistics shaping the future of medical billing and coding.

The Growing Challenge of Medical Debt

  • Medical debt is a looming crisis. 50% of US residents carry medical debt, a 4% increase from 2020.
  • 48% of US households incurred healthcare expenses last year, with 17% experiencing costs of $1,500 or more.
  • Surprisingly, an estimated 80% of US medical bills contain errors, resulting in substantial financial losses.

Economic Factors Impacting Consumer Medical Spending

  • Since 2011, average family premiums have soared by 47%, outpacing the increase in wages and inflation.
  • For many, out-of-pocket expenses remain daunting. Even affluent consumers sometimes avoid seeking care due to the costs associated.

Technological Innovations and Their Impact

  • The global medical billing outsourcing market is projected to reach an impressive $20.98 billion by 2026. This growth is spurred by technological advancements, notably cloud-based medical billing systems.
  • Despite the growth, many providers still rely on traditional methods. A significant 75% of providers use paper and manual processes for collections, indicating a vast potential for modernization.

The Push for Price Transparency

  • Introduced in 2021, the Hospital Price Transparency Law aims to provide clarity on healthcare costs. However, the actual impact is yet to be realized, with many healthcare providers not fully compliant.
  • A worrying 87% of consumers were taken aback by a medical bill in 2021, highlighting the need for transparency and clarity in billing.

The Changing Face of Medical Billing and Coding Jobs

  • As the field expands, professionals in medical billing and coding are in high demand. Medical coding and billing have an 8% projected job outlook, outpacing many other industries.
  • The urgency to fill these roles is highlighted by the fact that dealing with staff shortages is now the primary concern of provider CEOs.

Telehealth and Digital Payment: A Modern Approach

  • The COVID-19 pandemic has dramatically altered healthcare delivery. Telehealth usage has surged 38x from its pre-COVID-19 levels, with half of providers continually improving their telehealth options.
  • As medical care goes digital, so does the billing process. A significant 85% of millennials express a willingness to use a mobile app for medical bills.

The Disconnect Between Providers and Consumers

  • While the statistics suggest a significant shift towards digitalization, some providers are lagging. A sizeable 39% of providers believe that billing and collection do not influence the patient experience. This is in stark contrast to consumer sentiments, particularly among millennials, who are willing to switch providers for a better payment experience.

The Role of Automation in Improving Efficiency

  • Automated administrative practices are not just about convenience—they bring substantial financial benefits. Such practices save providers an estimated $166B annually, emphasizing the crucial role technology can play in modern healthcare.

Embracing Regulatory Changes and Compliance

As the healthcare industry grows in complexity, staying updated with regulatory changes becomes paramount. Not only do these changes dictate best practices, but they also play a pivotal role in determining the reimbursement mechanisms and ensuring fair practices for both providers and patients.

  • The introduction of the Hospital Price Transparency Law underscores the healthcare industry's need for clarity and fairness.
  • However, with 83% of hospitals not complying with at least one major requirement of the CMS price transparency rule, the path to complete transparency appears challenging.
  • Moreover, while 91% of consumers are unaware that hospitals are required to disclose their prices, it emphasizes the need for education and communication between healthcare providers and consumers.
  • Regulatory compliance not only reduces the chances of heavy fines but also ensures that patients can trust their healthcare providers, further strengthening the provider-patient relationship.

Staying updated with these regulations, understanding their implications, and implementing the necessary changes is vital for a smooth and transparent billing process. Tools and solutions like Adonis can be instrumental in navigating these changes, ensuring that institutions remain compliant while delivering top-notch patient care.

In Conclusion: The Adonis Advantage

These trends highlight the importance of adapting to the rapidly changing medical billing and coding landscape. As providers seek to streamline processes and enhance the patient experience, solutions like Adonis are at the forefront, offering innovative, effective, and efficient solutions for modern healthcare challenges.

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