The Expanding Role of Medical Billers and Coders

Published: Wed, 05/14/25

Updated: Wed, 05/14/25

Link to all things medical coding & billing

The Expanding Role of Medical Billers and Coders

As the healthcare industry continues to evolve in 2025, the demand for skilled medical billers and coders has reached unprecedented levels. This growth is fueled by ongoing changes in healthcare regulations, the expansion of electronic health records, and the increasing complexity of insurance reimbursement processes. For those considering...

Autonomous coding with AI shows impressive results at OHSU

Oregon Health & Science University Hospital is a 576-bed teaching hospital, biomedical research facility and Level I trauma center located on the campus of Oregon Health & Science University in Portland. It is at the heart of OHSU, a large health system of hospitals and clinics across Oregon and southwest Washington. The Challenge...

Sepsis and HCCs – Too Many or Too Few?

Like many of you, I am deathly allergic to clinical documentation integrity (CDI), but do not worry; I premedicated with prednisone and an antihistamine prior to writing this article. I know it is critically important that doctors use the right terminology for diseases so that all those agencies – both governmental, like the Centers for Medicare...

Beyond Coding: How CDI is Reshaping Compliance and Revenue

Clinical documentation integrity (CDI) has matured beyond its initial focus on coding accuracy and Diagnosis-Related Group (DRG) optimization. In 2025, it is central to payer compliance, audit defense, risk adjustment, and sustainable revenue. This article will explore how CDI professionals are bridging gaps between clinical care and financial strategy by...

CMS sets up real-time medical fraud center with DOGE; Federal contractor rolls out commercial tool

The Centers for Medicare & Medicaid Services (CMS) has launched the Fraud Detection Operation Center (FDOC) to fight waste, fraud and abuse, the agency announced this week. Listed on a new webpage are a list of “recent success stories.” They include taking action against improper enrollment in Affordable Care Act (ACA) plans, cracking down on false billing of...

Breaking the ‘intellectual bottleneck’: How AI is computing the previously uncomputable in healthcare

Whenever a patient gets a CT scan at the University of Texas Medical Branch (UTMB), the resulting images are automatically sent off to the cardiology department, analyzed by AI and assigned a cardiac risk score. In just a few months, thanks to a simple algorithm, AI has flagged several patients at high cardiovascular risk. The CT scan doesn’t have to...

P.O. Box 3824
Youngstown OH 44513
USA

Unsubscribe | Change Subscriber Options