Artificial Intelligence and Medical Coding

Artificial intelligence has the capacity to boost billing businesses. Artificial Intelligence has changed so many industries. According to recent research, artificial intelligence is going to change medical coding.

What is Medical Coding and Billing

Coding and billing is a process in which recognized Codes that categorise patient data records and direct billing towards insurance companies are used. Coding and billing seeks to create average billing costs that are determined by patient data.

The medical coding industry has had challenges of revenue cycle due to various factors that include COVID-19 as well as errors that are usually found too late due to the nature of audits in the medical industry. Hospitals lose billions due to these errors

Traditional Medical Billing and Coding Process

Manual medical coding is a complicated job that involves a high amount of workforce.  A lot of manual documentation and paperwork is also involved when it comes to traditional medical billing and coding systems.

Claims that are made on paper take time to process because coders will take time to put all the codes on the printed paper. The paperwork is then taken to billing organisations before being taken to the payers. Paper work takes 5 to 7 weeks and if an automated billing system is used, it will take only 2 weeks.

The Process of Claim to Payment using Paper

  1. Patient’s visit to the doctor’s office.
  2. Check in and treatment of the patient
  3. Writing of the superbill by the doctor or assistant
  4. The medical coder then puts in medical codes
  5. The paper forms are then taken to the medical billers, they then format the data and send it to insurance payers.
  6. The insurance company then verifies information and pays the provider

AI Automation and Medical Billing

There are a lot of challenges when it comes to coding being accurate. There are Artificial Intelligence apps that simplify manual coding and these apps are being used in many medical institutions. Computer Assisted Coding (CAC) is the technology behind medical coding Artificial intelligence.

This technology is able to extract information from documents and enter it into the system.  Artificial Intelligence can reduce hours that humans work as well as human error.

What Artificial Intelligence Solves

The major worry that the medical coding industry has is that Artificial Intelligence will shrink the jobs that are currently available. The Artificial Intelligence Apps help in the sense that it can increase the efficiency and speed of human coders.

Human coders can now accurately code through Artificial Intelligence but the technology cannot replace them totally. The coding Artificial Intelligence Apps can detect mistakes that are made by humans and they try and suggest ways to fix it.


Medical coding is very important so there is a need to eliminate mistakes in order to make sure the healthcare system is properly managed. If the healthcare institutions do not get payments for their services, they will have financial challenges which is why accurate coding is needed.