The latest reforms have changed the healthcare sector drastically. Most importantly, healthcare billing and coding regulations have made financial management more complicated than ever before.
We all know that the Healthcare industry is directly connected to us in almost all possible ways, such as: emotionally, physically, mentally, and financially. This signifies that even minor changes in this industry have direct impacts on our lives.
Moreover, the ongoing pandemic leaves negative impacts on the medical industry, particularly the US healthcare system has suffered a lot. Medical practitioners have to shift their attention from research across medicine, social care and other non-emergency services to tackling the ongoing crisis.
We are living in an era, where previous technologies have reached their peak and new technologies are on the verge to make a drastic impact on our lives. In addition to this, many factors such as disease trends, doctors’ demographics, and technology are involved in changing the industry. As our society evolves, our healthcare requirements naturally evolve.
Here are the following factors that are shaping the future of the US healthcare industry.
- Virtual Care and Remote Medicine
The trend of virtual care and telemedicine witnessed a surge from last year and it still continues in 2021. Due to this shift, the importance to keep pace with healthcare billing and coding regulations has been increased. Because in order to stay financially fit, it is also necessary to follow the latest trends in medical billing.
As well as reducing the risk of spreading viral infection, remote medicine allows healthcare providers to provide medical assistance to the patients. The emergence of telehealth has revolutionized the US healthcare system.
For example, the use of technology has become a crucial aspect of our lives. As the doctors are using electronic solutions to provide medical services. It wasn’t easy for both patients and doctors to quickly adopt this trend. They have to face several challenges in keeping consistency in telehealth.
- Constant Changes in Medical Coding
Medical coding plays a crucial role in the entire healthcare revenue cycle management. Insurance companies get information about patients’ diagnosis, symptoms, treatments, and medical procedures from these codes.
Moreover, the field of medical coding has been witnessing constant changes for the past 20 years. Before the emergence of digitalization, medical coding and billing was a very hectic and time-consuming task as medical practitioners kept patients’ files in large folders.
In this digital era, medical practitioners have stopped using manual methods of record-keeping and medical billing. They use electronic medical records to keep track of patients. It was a great reform in the healthcare industry.
In addition to this, the recent changes in healthcare billing and coding regulations have changed the pattern of insurance claims entirely. The switch from the ICD-9 to the ICD-10 coding system made evolutions in the rules and regulations of medical billing and coding. These advancements have made medical coding extremely complicated. Because it contains a multitude of medical codes.
Therefore, it is crucial for medical coders to undergo constant training to keep themselves updated with the new, deleted, or modified healthcare billing and coding rules.
Because without in-depth knowledge about the latest trends, they cannot process the medical claims as per industry standards, which can lead to claim denials. So, the need for pepper training in the medical field is increasing with every passing day.
While the ICD-10 coding system has streamlined communication with insurance companies, the requirements to become a medical coder are more stringent. This makes quality education more important than ever.
- HIPAA and Federal Laws
The US federal government has introduced the latest laws that regulate the entire healthcare industry. HIPAA is one of the biggest laws that has created many changes in the medical industry in the last decade. It contains lots of new healthcare billing and coding regulations.
Patients’ confidentiality is the most important aspect of this law which ensures the protection of Protected Health Information (PHI). Therefore, it is essential for medical practitioners to stay compliant with this act.
This also includes requiring every employee in a medical office to sign a form stating their commitment to protecting the highly confidential patients’ information.
Another requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) is to educate the patients about their rights and assure the confidentiality of their medical information.
One of the most important HIPAA legislation is the enactment of HIPAA 5010. This is a requirement to keep the patients’ electronic data confidential according to HIPAA standards. A further requirement of HIPAA is the use of ICD-10 codes, which allow for more specificity in the reporting of patient diagnoses.
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