AI Revolutionizing Medical Billing: Efficiency, Accuracy, and Fraud Prevention
The use of artificial intelligence (AI) has increased. We read AI-related news every day, such as what AI can do for a particular industry. Every industry is somehow affected by the latest technology. Similarly, the healthcare industry is not immune to this newest innovation. We know that AI is already somehow used in the operating room, but its use is now expanding. AI is being adopted by doctors and hospitals, from medical billing to minimizing fraud. Will AI reduce the costs? And how will AI affect patient care?
AI Fundamentals and Healthcare
AI is not limited to basic laptops or any computer software. It is a computing platform that is capable of making intelligent decisions. AI can learn, and its computational techniques can learn from predefined rules. Also, machine learning uses algorithms that learn from data to describe, improve, or predict outcomes. Once AI is modified and taught, it learns and evolves in response to the given tasks.
For example, a machine could be taught to identify brain tumor pictures from a magnetic resonance imaging (MRI) image. This way, AI will learn other ways to determine the brain tumor independently. It could identify the tumor that people weren’t searching for explicitly.
Natural Language Processing (NLP) is the AI’s ability to closely understand the human language. It then transforms the unstructured text into structured data that the machine can read. An NLP example is translating the interaction between a patient and a doctor into a note.
The use of AI in healthcare is rapidly growing. It offers benefits such as personalized patient care, enhanced diagnostic accuracy, and efficient administrative task automation. According to a recent report, the global AI medical market is valued at $20.9 billion and is forecasted to reach $148.4 billion by 2029.
Medical Billing and Coding
There are over 70,000 codes used in the medical billing world that human coders use to process charts.
At present, it’s a time-consuming manual task. With the increasing speed at which healthcare works, the entire process is inefficient to complete in time. It is common that errors are made, that cause denied claims. The workload keeps increasing, as the older population needs more healthcare.
Human coders work regularly, but AI works 24/7, that’s why billing will be prepared faster. AI is efficient and does not miss any code. This means that you won’t be billed for services you didn’t get. This way, the claim is not denied by your insurance carrier because of the wrong code.
In the medical billing world, AI will take over the role of medical coding and only fewer manual coders will be needed. The existing coders and workers can be promoted to supervisory roles or can handle the tasks that need human attention.
Anything that deals with patient data must be Health Insurance Portability and Accountability Act (HIPPA) compliant. All AI that works on this sensitive information must meet this mandatory standard. The savings healthcare providers in USA and hospitals have due to AI, medical billing, and coding can lower healthcare costs.
Preventing Healthcare Fraud
Billions of dollars are lost due to fraud in healthcare. AI can identify suspicious claim activity or anomalies. It can also spot false payments, billing data, or any hospital data. A large amount of data can be analyzed, which allows fraud analysts to address issues before big losses occur.
AI can understand human language because of NLP. It will be able to notice claims being submitted from suspected locations or incoherent data that humans cannot see.
Also, Computer-aided diagnosis (CAD) uses AI to identify and analyze the images. Both pathology and radiology use it to help diagnose diseases. It is improving with the addition of the latest AI. AI analyzes images more accurately because there are fewer false positives. AI can automate the process of helping detect diseases. The result is more accurate and requires fewer biopsies.
Lastly,
AI may seem like something something straight from Sci-Fi but it is working now in the healthcare industry, especially in medical billing. It is set to save billions of dollars through medical billing, coding, and fighting against fraud.
The best benefit of AI advancement is that it reduces costs and helps patient care. Most importantly, patient confidentiality is crucial, and AI must have to adhere to HIPPA compliance. AlphaCure ensures 100% protection of patient data by staying compliant with HIPPA. We have gained our client’s trust by providing them with top-notch medical billing and coding services with full data protection. Contact us now to learn more about our service in USA.
