Healthcare and automation? For many, the two remain an unlikely couple. The knee-jerk reaction to “automation” is to think of industries like banking, finance, manufacturing, logistics, or retail. A few will associate the medical sector with robotics.

On the surface level, it’s easy to see why healthcare is inherently more human-centered compared to other industries. That’s because health is a delicate matter and should be handled with exceptional empathy, care, and expertise that only living and breathing doctors, nurses, technicians, caregivers, and other staff can ensure.

However, any healthcare executive knows that no medical procedure could be delivered without dozens of menial back-office tasks. These necessary chores take hours, diverting medical staff from providing care and taking a heavy toll on their efficiency.

The good news is that these are precisely the tasks that can be automated.

Repetitive, patterned, and prone to errors, insurance billing, and coding are fundamental activities that modern healthcare businesses delegate to Robotic Process Automation (RPA). What is involved in the process, and how do hospitals, practices, and healthcare professionals benefit? Let’s dive into medical coding automation and its implementation, from discovery to continuous development with experienced RPA consultants.

Despite its significant role in the healthcare and insurance industries, medical coding is often put down as another back-office job. While this is a huge generalization, there’s one truth: medical coding is foundational for the efficiency of healthcare-related processes.

First, we can’t delve into medical coding without mentioning medical billing. The two go hand in hand, and the same person often performs both tasks (especially in smaller practices). However, the scope of the two activities is quite different.

The main activities within the medical coding business are the interpretation of patients’ diagnoses, test results, and procedures and converting them into one of the standardized classification systems, such as the International Classification of Diseases (ICD), Current Procedure Terminology (CPT), or Healthcare Common Procedure Coding System (HCPCS).

Next, medical billers use these codes to handle insurance claim submission, reimbursement, and billing patients for medical services. Also, medical billing relies on the data translated by medical coders, facilitating communication between healthcare providers, patients, and insurance companies.

On the other hand, medical billing is just one of the many applications of codified medical records. Between EHR, insurance claims, administrative data, surveys, and trials, there’s a massive amount of data to process in healthcare daily.

In this context, having a set of unified codes instead of thousands of terms for procedures, medications, and conditions is a true lifesaver when managing the information flow. It supports:

Medical coding helps ensure that all parties in a healthcare ecosystem stay on the same page and communicate smoothly and efficiently.

Medical coding — what can you automate?

All of that sounds great, but it’s important to remember that such an efficient flow of healthcare data is only possible thanks to the everyday work of medical coders. Unfortunately, similar to medical billers, their job can get very repetitive.

The usual workday of a medical coder consists of going through medical records, interpreting them, and assigning them appropriate codes. It is an arduous task and one prone to errors, especially after several hours of mapping lines of text to digits. Thankfully, automated bots are capable of assisting coders with many of these tasks

Read more about claims processing automation and find out how it can improve your claims management immediately.

Pre-programmed scripts have a proven track record of handling similar duties in related fields, from medical billing to insurance.

Before you conclude that medical coders will soon become obsolete, there’s one important caveat. While many records fall into a predefined category, they can get tricky when patients have a long and winding medical history. In such cases, the expertise of a trained, highly-qualified human coder is crucial.

For this reason, as medical coding automation progresses, we’ll still see human coders. The US Bureau of Labor Statistics predicts a 9% employment increase for medical tech specialists, including coders. However, rather than being replaced by bots, they will work in tandem with them as auditors. The result? A human-machine dream team that can process code with far greater speed and precision than one person alone.

Medical coding automation tools

The word “automation” is an umbrella term that covers multiple solutions. The three most relevant to the medical coding automation business are computer-assisted coding (CAC), AI, and RPA. These technologies are poised to define the future of back-end healthcare automation.

Conclusion

Medical coding is one of many repetitive but essential administrative tasks in healthcare that can benefit from robotic process automation. This shows that the potential for RPA to become an industry-defining tool is surely there. Affordable and effective, RPA is also the perfect stepping stone into the world of automation.

So if you’re looking to optimize your medical insurance billing and coding workflows, you’ve found the right people for the job. Send us a message and discuss how we can make your organization more efficient by providing RPA consulting services.