Are the government’s efforts to make the process of medical coding and billing electronic reducing health costs? Or is electronic coding making it easier for doctors and health-care workers to exaggerate the work they do and bill more? It’s not pleasant to think that some of the doctors whom you trust with your life are not worthy of that trust.
If you’re planning to enter a career in medical billing and coding you need to understand how these money matters work and understand how you can be part of the solution. But first:
What is Medical Billing and Coding?
According to the Bureau of Labor Statistics, the medical coding and billing career falls under Medical Records and Health Information Technicians and has a great job outlook which means more jobs will be available in this field in the future.
Medical Billing and Coding professionals keep patients’ medical records. They carry out various managerial and organizational tasks related to record keeping and help determine how much the patient is to be billed depending on what the hospital or clinic was able to do for the patient. They must learn and use a medical coding system that assigns different codes to various procedures in order to bill accurately.
For a couple of years now the government has been offering many hospitals incentives to switch to an electronic form of coding and billing. Their purpose was to cut health costs by cutting the hours spent paying workers to code and file the paperwork that doctors had to fill-out. It was a good idea but it all went wrong.
An article in the New York Times website details the many flaws of electronic coding and billing. The bottom line is that the ease of electronic data entry has made it easier for doctors to exaggerate the care they provided so that they would be paid more. By a simple click of a button patient records can be copy-pasted and procedures that never took place can be added to an insurance claim. It’s so easy to say that the patient underwent a standard physical examination when the doctor may have just taken a cursory look at the problem. Certainly, there are many honorable doctors but the numbers don’t lie. Fraudulent, exaggerated claims are filed all the time. Healthcare analytics solutions are implemented to solve the issue, but not as widely as patients would want.
A Possible Solution
Since the system of coding and billing in use now (ICD-10) is vastly outdated, the ICD-11 is scheduled to be implemented in most hospitals in January 2022. According to the ICD-10 guide, the ICD-10 which many countries have adopted years ago has at least 2 features that will help battle fraudulent claims.
It is more specific: The more specific you can be about the care provided, the more accurate the amount charged will be. The software used for this coding system will have some ability to detect an exaggerated claim. Technology which can be manipulated can also be used to safeguard itself from manipulation and streamline various medical processes, thus saving millions of dollars.
What does that mean to you?
Now for the best part, you can help use technology well and promote legitimate claims. If you want to be a medical coding and billing professional, you can enter CareerStep’s Medical Coding & Billing program and learn to use the ICD-11. Even if you are already working with the ICD-10, you can take a 16 week course offered by their corporate training program. This only demands 2 hours every day to learn the new system. You won’t even have to take a day off since the entire program is online. This is a growing field so finding a job will not be difficult.
If you can work with computers and care about people then a career in medical coding and billing is right for you. You can help save billions by getting qualified to use the ICD-11 coding system and reduce the existing burden electronic billing seems to be putting on the system.
Summary: Medical coding and billing electronically seems to be failing in accuracy, increasing health costs and burdening the system. The ICD-11 is one tool that can be used to reduce the existing fraudulence. You, as a Medical Coding and Billing professional can be the best defense against exaggerated claims.