Impact of medical billing and coding regulations on the healthcare industry

Billing & Coding Regulations

Billing & Coding Regulations

Healthcare is a fast-pacing industry in the US marketplace. It has a great impact on the annual GDP of the US market. The consistent implication of regulations increases the pressure of new rules, new procedures and increasingly stringent policies on the medical workforce. It is the most complicated task for the physicians to comply with these modifications and rely upon their ongoing strategies. Therefore, there is always room for advanced knowledge of medical billing and coding for the physicians’ office, which can help them to comply with the ever-evolving standards.

According to a recent study, the healthcare industry can be over-regulated for many providers including; physicians, hospitals and other health centers, etc. that it would implement undue levels of stress and errors. The constant growth and change in healthcare regulations continually add layers of bureaucracy that can cause irresistible stress on healthcare workers, especially on medical billing and coding professionals.The continually updating regulations of medical billing and coding standards can impact the healthcare industry in the following ways;

Ever-evolving medical coding environment

The most significant change is the advent of the ICD-10 coding system, which replaced ICD-9 in October of 2015. This updated coding system nearly quadrupled the volume of diagnostic codes from 14,000 to 68,000, while procedure codes jumped more than 2,000 percent, from 4,000 to 87,000 codes.The advancement of ICD-10 codes has led to misinterpretation in terms of the workplace, causing mistakes, overwork, and limited time to complete medical billing procedures. Therefore, it has increased the chance of occurrence of more claim denials and minimized reimbursement rates.

Increase work pressure on healthcare workers

The change in the standards of the medical code has also led the medical billing professionals to rigorously undergo the pressure of claim denials due to the series of consistent modifications in the medical coding regulations.Therefore, this workload pressure has ultimately resulted in unintentionally claim denials, and an increase in overtime costs, financially choking physicians, all while reducing the quality of patient care, which provides education and training to the medical office staff at hospital systems, medical societies, and educational institutions nationwide.

Mistakes in medical billing are costly to the healthcare industry

Erroneously prepared medical bills can adversely affect the financial strength of the healthcare marketplace than any other possible factor so far. It doesn’t only cost the industry, employers but it also has a significant effect in lost reimbursement. These errors can also cost valuable time, and quality—directly impacting patient health.

Engaged Staff in Wake of a Change in Regulations

The most essential requirement to sustain compliance with the regulations of the healthcare industry is the qualified, experienced and engaged staff. High-quality, ongoing staff training is paramount to sustaining a cohesive, engaged team and minimize preventable errors. Medical billing and coding staff can contribute a lot to the success of the healthcare industry in the form of clean and efficiently expedited claims.

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