In today’s healthcare industry, medical coding is the primary way that providers, facilities, and insurers communicate with each other about your care. You can learn more about what coding is and how it works in this article, but as a recap, every treatment, visit, procedure, drug, and device has its very own code attached to it. When you or your insurance company get billed, those codes are listed, and how much you owe is determined based on those codes.
Medical coding is a simplified way to exchange information and record transactions, but it’s still extraordinarily complicated for the average patient to understand. That’s why it’s so unnervingly easy for patients to be overbilled…and why it’s so difficult to spot medical fraud.
How can you tell if something is wrong if you don’t know what you’re looking at?
Below, we’ll discuss some of the top reasons why it’s so difficult to understand billing, as well as why it’s bound to become even more complicated—and what you can do to protect yourself.
New codes are always coming
When it comes to coding diseases and diagnoses, we are currently using version 10 of the International Classification of Disease codes (referred to as ICD-10 in the industry). But as medicine evolves, so does the ICD; in 2022, the United States will adopt ICD-11, which we expect will contain thousands of new codes for billing specialists to learn.
Medicine is hardly a static field, and as new treatments become available, you can expect the various types of codes to expand and evolve with the industry. That’s great job security for medical coders and billing specialists, but not for the patient trying to read their bills.
Medical coders are turning to AI to help
More and more industries are turning to computers to help them get various jobs done. Artificial intelligence (AI) can and does help medical coders by streamlining their processes, even allowing them to automate certain tasks. AI can help ensure codes are accurate, but a human still needs to work with the machine—it’s nowhere near becoming a hands-off process.
Medical coding requires its own education
Medical coders aren’t going to just figure out AI as they go. They’ll have to learn how to work with the new technology, as well as update their existing skill set as new editions of codes are released. They’ll generally need to get certified or get an associate’s degree, and pursue further education as necessary.
When you take the education levels, ever-changing codes, and the addition of computers to the field, you can understand why so many instances of healthcare fraud at first go unnoticed. People without training just don’t know what to look for—and when they do realize something is wrong, they’re already out thousands of dollars.
Help protect yourself with HealthLock
You shouldn’t have to become a professional medical coder—or get access to an AI!—just to understand your bills. HealthLock will do the heavy lifting for you.
We do have a powerful AI, along with experts in medical coding, and together we’ll monitor your medical transactions and Explanations of Benefits to make sure everything is as it should be. If we do notice something is wrong, we can help clear your record and recover damages, too.