In this Article
By: Maddie Cohen
Professional insights: Sarah Anderson
Technology is transforming medical billing and coding as we know it. Students looking to enter this field serve hospitals, clinics, nursing homes and other healthcare facilities—making sure providers are paid for the exact services they deliver. In order to be successful in their role, medical billers and coders must be prepared to use numerous different technological tools.
What is medical billing and coding?
Medical billing and coding professionals handle tasks related to patient billing and collections. They serve as intermediaries between healthcare providers and insurance companies, making sure that facilities are reimbursed correctly by insurance companies.
To do this, these allied health professionals translate physicians’ notes and services into standardized codes. The codes help streamline the payment and claims management processes.
Medical billing and coding roles require a deep understanding of manuals like the:
“Once students get used to the coding manuals, they have all the medical coding guidelines and resources at their fingertips,” said Sarah Anderson, a medical coding and billing instructor at Southeast Technical College in Sioux Falls, South Dakota.
Technology used by medical billers and coders
Medical coders focus on accurately documenting the care healthcare providers deliver, while medical billers handle the financial transactions and claims associated with those procedures. Both roles keep the healthcare revenue cycle running smoothly, and both rely heavily on specialized technology.
Tools like the 3M™ 360 Encompass System seamlessly translate dictated medical information into unique codes. However, there’s a real need for human oversight when using this technology. Medical coders should always review the system’s output before submitting a claim.
While medical billing and coding students may first learn coding through the traditional manuals mentioned above, most programs also integrate encoder software solutions like 3M’s into the curriculum. The aim is to make sure students are familiar with the technology they will soon be using in the field.
Key medical billing and coding technology terms
Technology makes the work of medical billers and coders faster, more accurate and compliant with regulations. These are some of the technology terms medical billing and coding students should know.
Encoder software
Encoder software automates the process of finding and assigning the right medical codes based on patient records. This software lets coders enter medical terms and receive suggestions on coding pathways.
Many hospitals use 3M’s encoder software, although smaller practices may prefer the more affordable Optum solution.
“Encoder [software] gives us all of the coding guidelines and resources,” Anderson said. “That way we can click on any coding guidelines or clinic clarifications that are posted and choose the right codes in specific scenarios.”
Anderson emphasized that encoder software solutions are a one-stop shop for all the resources professional coders need to use. They also help medical billing and coding students gain the tools they need to excel in their future careers.
Electronic Health Records (EHR) systems
EHR systems digitally store and manage patient health information—including diagnoses, treatments and medical histories. Medical coders access these records to extract the information they need to assign the right codes.
EHR systems like Epic and Cerner (which was acquired by Oracle in 2022) are often used in larger healthcare institutions like hospitals. They offer a truly comprehensive view of patient care.
Natural Language Processing (NLP) tools
NLP tools like the abovementioned 3M™ 360 Encompass System automatically translate dictated physician notes and other medical documentation into standardized codes.
While they may increase efficiency, medical coders need to carefully review the output of these technologies—especially for complex medical cases or combination codes.
Practice management software
Practice management software handles healthcare practices’ administrative and financial tasks, including scheduling, billing and claims submission. These solutions help coders and billers track all the claims they submit—and make sure they are processed in a timely manner.
Software solutions like Athenahealth and Kareo integrate medical coding, billing and claim management functions.
Claims management software
Medical billers use claims management software to submit and track the status of insurance claims. These solutions drive compliance with payer guidelines and help billers handle claim denials when they come up.
Availity and Change Healthcare are examples of tools—known as clearinghouses—that process claims on behalf of healthcare providers. Clearinghouses prescreen and clean medical claims data, making the claims submission process faster and more accurate.
Computer-assisted coding (CAC) software
CAC software analyzes clinical documents and suggests medical codes based on the relevant data. While this automates some aspects of coding, medical coders still need to review the accuracy of the recommended codes.
TruCode by TruBridge is an example of CAC software—and the 3M™ 360 Encompass System also uses CAC. These solutions suggest unique codes based on patient documentation, but they are no substitute for a human medical coder.
Virtual private networks (VPNs)
Many people are familiar with VPNs, but not everyone knows the role they play in the medical field. VPNs let medical billers and coders securely access EHR systems and sensitive healthcare data from anywhere. This technology makes remote work possible in the medical billing and coding field.
Many hospitals, for example, use VPNs to allow coders to work from home without compromising the security of patient records.
Code auditing tools
Auditing tools review medical claims to verify that coding and billing practices comply with regulations and guidelines. These tools help identify errors before claims are submitted, reducing the likelihood of claim denials.
These are just some of the technologies medical billers and coders use in their careers. Technology also plays an important role in medical billing and coding education programs.
Technology used in medical billing and coding education programs
Medical billing and coding professionals need to work quickly and accurately. This is where a comprehensive medical billing and coding education may come in.
Looking beyond the tools medical billers and coders use in their careers, students in the field also rely on technology. Most medical billing and coding education programs prioritize technology to simplify learning.
For instance, many programs rely on a Learning Management Systems (LMS). LMS platforms like Blackboard and Canvas let instructors deliver course materials, quizzes and lectures online—giving students easy access to resources and promoting a flexible learning environment. Through these systems, medical billing and coding students can engage in discussions, submit assignments and track their progress.
Video conferencing tools like Zoom and Google Meet are also common, especially in remote learning environments. These platforms allow students to attend lectures and collaborate on coding exercises from any location. Recorded lectures are another key feature, giving students the ability to revisit complex lessons at their own pace.
For hands-on learning, some programs use simulation software that mimics real-world coding scenarios. These platforms let students practice coding medical records, submitting claims and troubleshooting billing issues. The objective is for students to apply what they’ve learned in a safe, educational setting before they handle actual medical records on the job.
Finally, many medical billing and coding programs encourage the use of research tools like YouTube to supplement learning.
“We will watch animated videos to visualize what’s happening,” Anderson said. The medical coding instructor notes that these types of resources help students understand the context behind the actual codes they assign.
Closing thoughts
Technology plays an indispensable role in medical billing and coding—shaping how students learn and how professionals work in the field. Many different tools are available to streamline processes, improve accuracy and enhance productivity. However, instructors like Anderson stress the need to focus on both manual and technology-based learning as students pursue their certifications.
Although technologies like NLP are evolving quickly, it’s important to remember they still require human oversight and expertise. Coders must understand how to use these tools without sacrificing accuracy or compliance. This is where continuous learning comes in.
“You have to adapt to the newest technologies,” Anderson said. “But these technologies still need a human person to check everything.”
It’s undeniable that even more technological advancements, such as AI, will impact the medical billing and coding industry. That said, human coders will still play an important role in the space. After all, only they can protect the integrity of the healthcare documentation and reimbursement information they oversee.
Looking past technology, most professionals also find this career path highly rewarding.
“Medical coding is really like doing a puzzle,” Anderson said. “You learn so much about the healthcare system and payments that it helps you when you go to the doctor. You end up helping your family members, too.”
The benefits of medical billing and coding are truly expansive, and there’s a lot of opportunity in the space. Technology is just the beginning.
Are you interested in learning more about becoming a medical biller or coder? Explore our allied health programs for more information on how to get started.
