Medical Billing Services – What to Expect in 2019

2018 witnessed many changes, from rise of automation to increase in medical billing outsourcing. With the advent of 2019, it is a critical time for every provider to look out for latest changes in medical billing services. For healthcare practices, efficient revenue cycle management is the most important element of success and in order to achieve a seamless cashflow, practices will have to focus on having systematised medical billing.

Medical Billing
Medical Billing

Following are few of the key changes and trends to expect in medical billing services in 2019:

  • ICD-10-CM code changes. The 2019 ICD-10-CM codes changes that CDC published on June 11, will continue to be used from October 30, 2018, to September 30, 2019.  To an existing complicated coding system, 2019 ICD-10-CM brings some new code changes. There are a total of 473 code changes, which includes 143 revised codes, 51 deactivated codes, and 279 new codes.
  • Rise of Artificial Intelligence Applications. It has been estimated that by the end of 2019, AI for healthcare applications will likely surpass $1.7 billion worldwide. Use of machine learning and NLP (Natural Language Processing) is already being used by big firms for efficient coding and billing of medical services.
  • Payment changes for Part B drugs. The spending on Part B drugs by Medicare shows a staggering growth rate of 9.8% annually, from $17.6 billion in 2011 to $28 billion in 2016. To keep the incentives of physicians prescribing expensive drugs in check, CMS has introduced a new payment system for Medicare Part B drug, effective January 1, 2019. Under the new pricing index, the payment rate will be WAC plus a fee of 3%. P reviously, Part B drugs enjoyed WAC plus 6%.
  • Surge in Telehealth. As per the report from Transparency Market Research, a market intelligence company, by 2025, global tele-health market will reach $19.5 billion. In the US, the expected growth rate is 14.8%, and will likely hit the $2.8 billion mark. CMS is already working on telemedicine code changes in order to increase its use. Under the new coding changes, Medicare will be paying for virtual check-ins. Also, in 2019, CMS will be making some reimbursement changes in telemedicine services.

With new coding and pricing changes to be implemented in 2019, medical billing is going to be more complex than ever. However, relief comes in the form of development in automation and AI. The expectation of medical billing outsourcing market reaching $16.9 billion by 2021 suggests the reliability and efficiency of medical billing providers.


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