As a medical coder, you have diligently worked to acquire the knowledge and expertise necessary to decipher complex medical records and translate them into accurate codes. However, with the rapid advancements in technology, particularly in the realm of Artificial Intelligence (AI), there may be concerns about how these technological innovations could impact your job security. This blog aims to explore the role of AI in medical coding, its potential benefits, and whether it poses a genuine threat to your career in the healthcare industry.

Some people believe that AI will eventually replace medical coders altogether. However, it seems highly unlikely. AI can be a valuable tool for medical coders, but it’s not a replacement for human expertise.

The Truth About AI in Medical Coding

In the realm of medical coding, AI algorithms, and machine learning have proven to be incredibly useful in automating certain processes.

Here are some ways how AI empowers medical coders and healthcare facilities:

Hospital Appointment and scheduling:

While scheduling an appointment, AI tools such as Lightning Bolt allows hospitals to provide online booking for patients at their convenience, encouraging medical staff to focus on important tasks instead of spending time on these mundane tasks. With AI tools, medical staff can spend less time on appointments as the AI tools automate scheduling, sending reminders, and efficiently managing patient data for streamlined workflows.

Verifying Patient’s Identity and Insurance Information

Typically, medical staff calls the insurance company directly or else connect with them through an email to verify patients’ insurance policies. With AI automation tools such as  Athena One, this process can be expedited

Medical Coding and Charge Capture

According to a study by the Healthcare Financial Management Association, the average time it takes for medical staff to capture hospital charges without an AI tool is 10 to 20 minutes per patient. This includes the time it takes to review the patient’s medical record, identify the services that were provided, and assign the appropriate CPT codes.

The time it takes to capture hospital charges can vary depending on the complexity of the patient’s care and the experience of the medical staff. For example, a patient who has received a simple procedure may only take a few minutes to capture charges, while a patient who has received a complex procedure may take up to an hour or more.

The use of AI tools can significantly reduce the time it takes to capture hospital charges. AI tools can automatically identify the services that were provided and assign the appropriate CPT codes, which can save medical staff a significant amount of time.

For example, by using MEDICODIO’s AI-driven medical coding tool, coders can reduce the time it takes to assign code and capture hospital charges by up to 70%. This means that medical staff could capture hospital charges for a patient in just 5 minutes, instead of the 20 minutes it would take without an AI tool.

This indicates a rise in productivity.

Billing and claims management

Traditional billing and claims management relied on manual processes, leading to delays, errors, and inefficiencies. Staff manually handled billing, claim submissions, and follow-ups, often resulting in extended processing times and increased administrative burden. With AI-driven billing and claims management (Waystar), automation streamlines the entire process. AI can review claims for accuracy, identify potential issues, and even predict claim denials, ensuring faster, more accurate reimbursements and freeing up staff to focus on more strategic tasks.  

Patient payment and collections

Traditionally, patient payments and collections were handled through manual processes and limited technology. The integration of AI has significantly improved the patient payment and collections process, making it more streamlined, proactive, and convenient for patients and healthcare providers alike. Automation tools such as Sifthealthcare have revolutionized patient payment and collections by automating reminders, employing predictive analytics, utilizing AI chatbots to address patient queries, and establishing self-service payment portals, resulting in enhanced efficiency and higher collection rates.

Here are some tips for medical coders who want to stay ahead of the curve in the age of AI:

1. Become familiar with AI-powered coding tools: There are a few AI-powered coding tools available on the market. These tools can help you to automate tasks, identify coding errors, and get clinical decision support.
2. Stay up-to-date on the latest AI developments: The field of AI is constantly evolving. It’s important to stay up-to-date on the latest developments so that you can use AI to your advantage.
3. Develop your coding skills: Even though AI can automate some tasks, it’s still important to have strong coding skills. This will help you to interpret clinical data accurately and to choose the correct codes.

What are the Benefits of AI in Medical Coding?

1. 1. Increased Efficiency: AI can process vast amounts of data much faster than humans. By automating mundane and repetitive tasks, medical coders can focus on more complex cases and specialized coding requirements, improving overall efficiency.
   2. Enhanced Accuracy: Human coders are susceptible to errors, which can have significant implications for healthcare providers and insurance companies. AI, on the other hand, can minimize coding errors and inconsistencies, ensuring the billing and reimbursement process is more accurate and streamlined.
   3. Cost-Effectiveness: Implementing AI in medical coding can potentially reduce operational costs for healthcare organizations. By optimizing coding processes and avoiding potential coding-related issues, medical facilities can allocate their resources more efficiently.
   4. Real-Time Updates: AI algorithms can be continuously updated with the latest medical coding guidelines and regulations, ensuring that the coding practices remain up-to-date and compliant with industry standards.

Is AI a Threat to Medical Coders?

While the integration of AI in medical coding offers numerous benefits, it is crucial to address the concern of job security among medical coders. The reality is that AI is not here to replace human coders but rather to augment their capabilities. Here’s why AI should be seen as a complement rather than a threat:

1. 1. Human Oversight: AI in medical coding is a powerful tool, but it still requires human oversight. Complex medical cases, nuanced scenarios, and ever-changing regulations demand human coders’ critical thinking and expertise to ensure accuracy.
   2. Adaptability: Medical coding is not just about assigning codes based on data but also interpreting clinical documentation and patient history. AI may struggle with context-based understanding, while human coders can adapt to different situations and apply appropriate codes accordingly.
   3. Empathy and Communication: Patient care is at the heart of the healthcare industry. Human coders bring a level of empathy and understanding to their work, which AI cannot replicate. Moreover, medical coders often communicate with healthcare providers and insurance companies, bridging the gap between different stakeholders.
   4. Continuous Learning: Medical coders are lifelong learners, keeping up with the ever-evolving healthcare landscape. AI systems, although sophisticated, rely on the data they were trained on and may not be as capable of staying updated with the latest medical advancements and coding guidelines.

3 skills Medical Coders need in the AI-driven world: Code. Audit. Educate

As we step into an AI-driven world, the responsibilities of medical coders are expanding. They need to incorporate advanced technologies and get used to it. One essential skill for medical coders in this era is familiarity with AI algorithms. The ability to navigate and understand the intricacies of AI-driven coding systems is vital to accurately translate complex medical information into standardized codes. This proficiency not only enhances efficiency but also reduces the risk of errors, ensuring the integrity of healthcare data in an increasingly digitized environment.

Furthermore, medical coders must possess strong auditing skills to scrutinize automated coding processes and identify potential discrepancies. As AI systems become integral to medical coding, human oversight remains indispensable to maintain the highest standards of accuracy. Coders with the ability to critically assess and audit AI-generated codes contribute to the overall reliability of healthcare data, safeguarding against potential errors that may impact patient care and billing processes.

In addition to coding and auditing, education emerges as another key competency for medical coders in the AI-driven world. As technology continues to reshape the healthcare landscape, medical coders are expected to stay abreast of the latest advancements and continually update their knowledge base. The role of an educator becomes crucial as medical coders bridge the gap between technology and healthcare professionals, helping them understand the nuances of AI in medical coding and fostering collaboration for optimal patient outcomes. In this dynamic environment, the acquisition and application of these three skills – coding, auditing, and education – position medical coders as indispensable contributors to the seamless integration of AI technology in the healthcare domain.

Conclusion

AI is undoubtedly transforming the healthcare industry, and medical coding is no exception. While AI can enhance the efficiency and accuracy of coding processes, it should not be viewed as a threat to medical coders’ jobs. Instead, medical coders should embrace AI as a powerful tool that complements their skills and expertise. By working alongside AI systems, medical coders can elevate their roles, focus on more complex tasks, and contribute to better patient outcomes.

As the healthcare landscape evolves, medical coders must continue to adapt and develop their skills, embracing collaboration with AI to create a more efficient, accurate, and patient-centric coding environment. The future of medical coding lies in the synergy of human expertise and AI capabilities, ensuring a thriving healthcare ecosystem for all.