The Threat of AI to Admin Staff in Healthcare: What’s the Real Deal? - Medical Coding & Billing

To understand how AI will impact Medical Coding and Billing staff, we need to break down how this process currently works. Right now, about 50% of physicians handle their own billing, while the other half rely on billing administrators. Medical billing is based on various ICD codes and the complex rules that come with them. For those familiar with banking, the billing cycle is similar to a credit card cycle—there’s a cycle date, payment date, and a rejection and resolution process.

Files can be submitted to organizations like OHIP daily, although many billers only submit on a weekly or monthly basis. Tasks like reconciliation and eligibility checks are typically done manually. However, workflow automation is already stepping in to remove some of these manual processes, like file uploads to OHIP and Health Card Verification (HCV).

Now, with AI stepping into the scene, it’s a game-changer. AI can analyze ambient scribe data or notes taken during a patient encounter and predict the correct medical coding, including service and diagnostic codes. Predictive analytics has made huge strides over the past decade, and with the rise of Generative AI, this technology is now poised to take things even further. AI can predict and automatically add billing codes, significantly reducing the need for manual input. As a result, the role of billing administrators and assistants will eventually fade away.

RexBill addresses the majority of the requirements discussed here and is actively working to fill in the remaining gaps over the next quarter. Once this is in place, the need for a billing administrator will be eliminated for your practice. RexBill is an integral part of RexEMR Inc providing seamless integration with AI-driven automation that will make your practice more efficient and cost-effective.

The cost of running administrative tasks in healthcare is bound to decrease with Generative and Conversational AI. This shift will make medical practices more efficient and cost-effective, streamlining operations in ways we’ve never seen before.

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