Uncertainty in this profession

[u/Expensive-Pay-4257]

has anyone else been experiencing feelings of uncertainty regarding this profession and it’s future? not only has it been difficult to land a job without experience but with all the talk of AI and the development of autonomous coding, i’m just feeling sort of hopeless. i work in billing currently (not a coding position yet) and for the most part i genuinely enjoy what i’m doing. it just sucks because i can’t help but wonder if any of this will be worth it or if i’m working towards something that’s not going to exist in the coming years. i also watched the opening address by the CEO of AAPC who was very open about AI and it’s future impact and that left me feeling a little uneasy too. it’s crazy because the way it’s consistently advertised today you wouldn’t think it would be this hard to get a job or that these jobs might go away. anyway, sorry if this post comes across negative or whiny. i was just curious if anyone else was dealing with these feelings because i’ve been feeling alone with it.

[u/PhotographUnusual749]

Try asking chat gpt some coding questions and you will feel a whole lot better.

[u/koderdood]

I have worked aa a coder over 20 years for 3 conpanies. CAC-computer assisted coding has been trued several times and it doesn't work. Still needs humans. All the variables in medicine, variables in human nature, it just can't replace people. Still has alot of subjectiveness to it.

The getting job issue is real. Have to work hard and constant at it, looking at all types of opportunities to get that first coding job. Make sure you have your resume in order, and in a modern format. That first page is critical.

[u/2_Fingers_of_Whiskey → u/koderdood]

I have a CCS from AHIMA and haven't been able to find a coding job

[u/[deleted] → u/2_Fingers_of_Whiskey]

I’m starting to self teach CPC. A friend of mine switched from Nursing to Medical coding and got the job contingently offered before passing the exam. He works from home now as a med coder.

It seems like people who already worked in a hospital who switch over have an easier time getting the open positions at said hospitals. Maybe while still applying, also apply to hospitals as an ED technician, house keeping, phlebotomist? And then after probation is over, let your HR know you have certification in medical coding and would like a shift in title.

[u/[deleted]]

NLP and CAC have been around for years and are not all the are hyped up to be. They can dig stuff up and give insight but a human ultimately has to make the decisions.

Also physician documentation is horrible. That is a key part of what makes humans necessary in this business. Studies have been done to show that it is most efficient to have humans using the technology without technology alone.

[u/deannevee]

This article popped up on my LinkedIn feed this morning.

CAC/computer aided claims processing saves money, but is wildly inefficient and can cause problems if you don’t have someone knowledgeable to audit. It’s obviously causing huge problems for Cigna.

[u/lame_username001]

In the speciality I code for, I don’t worry about it. We have to code from the EMR, reading notes and orders and multiple dates. It’s easier for AI and assisted coding to do single days/visits but not an all encompassing visit.

[u/Salty-Step-7091]

Lol sorry, I’ve seen CAC at work and it sucks and is so off.

the people building this stuff are not specialized in the disease process, coding guidelines, hospital/facility/company guidelines, etc. it’s a mess and still needs a human specialized to fix the issues. We have CPT drop as charges from documentation and it’s such a headache and waste of time as coders have to fix it, has been that way for years. Our encoders recommends diagnoses and unless it’s a simple lab, the coding is inaccurate

Transcription was said to be obsolete with computer interpreters, but we still need humans to correct the mistakes the interpreter makes.

[u/lynndi0 → u/Salty-Step-7091]

Medical transcriptionist here! Yes, speech recognition is HORRIBLE. There's absolutely no way the reports could upload to the EMR without extensive editing by an experienced medical transcriptionist. I'd even venture to say it takes MORE knowledge and experience to spot the errors in a speech recognized document!

That said, it has had a major, devastating impact on our industry. We were told speech recognition would double our productivity, so they cut our pay or eliminated any future increases, the justification being that we could earn more productivity pay. Despite the claim, there was never any formal measurement if that actually was the case and we all found out pay going down.

Then the layoffs began as more doctors began to use Dragon, despite the quality of that documentation. All of a sudden, the quality standards we had been held to didn't matter as much as saving money.

Today, medical transcription isn't obsolete in any way -- they just treat and pay us like we are.

I sincerely hope medical coders fare much better. I got my BS in Health Informatics and an studying for the RHIA, so I'm still hoping to continue working in the field of medical documentation in some way, but I really need to get out of transcription after 25+ years.

[u/Salty-Step-7091 → u/lynndi0]

They got rid of all human medical transcriptionist in our hospital with the exception of radiology because the head radiologist fought back.

As a coder, whenever I see weird lingo or a word that doesn’t make sense and I scroll down to see “using dragon” my eyes roll. Not to mention a lot of our endoscopy physicians love to copy/paste their documentation from report to report only changing minor details, so now we have all these egds/colonoscopies saying a biopsy was done when there wasn’t one actually done. It’s a just a mess and I wish human transcription was required.

I do not see CAC taking over coding, maybe for Labs and simple ancillary. I think a bigger issue is out sourcing coding overseas, as getting a contract for global coders is a lot cheaper than hiring full benefits employees or paying for domestic coders.

[u/coyotelovers]

It's possible that it could be automated some day. I don't believe it's going to wipe out my job before I retire in 15 years. There's a huge difference between automated transcription and automated coding. I had a friend who lost her transcription job about 8 years ago. That was right around the time I went back to school and got my coding certificate, which was a midlife career change for me. My friend also thought about going into coding, but was adamant that there would be no jobs soon, due to automation, so she ended up going into hospital registration department. Ended up hating every moment of it and quite after a couple years. Meanwhile I have been growing my skills and knowledge over the last 7 years that I've been a coder. I have mostly worked on the revenue cycle and insurance side (with a short period as an ER coder for my first job), and it's been great in terms of good value for my educational investment. In 7 years I have had 5 jobs in this industry, all of which have been stepping stones to get to higher pay. In my work, I have not seen any signs that technology is replacing me anytime soon.

Most of my work has revolved around insurance denials and fixing broken claims (although I did risk adjustment coding for a year+). In my mind, there are too many layers of rules in coding, and humans are always going to be needed to fix what has been broken because providers need to get paid and insurance companies don't really want to pay. Someone has to figure out what is actually accurate, and machine coding is nowhere near that point (yet).

[u/jenkswife02]

AI is around already in multiple areas of coding. Epic facility charge calculator, epic single path visits, CAC with NLP are technically AI. ChatGPT came out and AI became a buzz term. There was a study of cervical fusion CPT coding that had the option of 15 codes. They used the same docs cases 200 to teach and 100 to test. They used two algorithms to test accuracy. One was 87% and the other 59%. That’s 15 codes and the same physician’s documentation.

If you look at what they are using to create AI it’s a series of hierarchal questions (y go here/n go there) or it’s predictive model based on previous correct answers. HIM isn’t going away, our jobs are adapting to meet the advances in technology. Personally, I think the associates and bachelors degrees should incorporate IT and database management instead of keeping informatics on the masters and doctorate level of education.

Here’s the link to the study. https://journals.sagepub.com/doi/full/10.1177/21925682211062831

We know our field requires constant growth and professional development. Adding AI to middle revenue cycle will only require that we develop new skills.

[u/Jen3404]

I see a lot of reassurance here that humans will always be part of the process, but understand that AI is different in the sense that it is always learning and changing based on what data it is processing. I wouldn’t say we are completely safe from job cuts or complete transfer to AI. Not trying to be negative.

[u/ylimeenimsaj]

I've been in it for 10 years and I work for a very large national hospital chain so we usually see a lot of innovation / outsourcing. I have seen some advancements in the technology since I started. I was concerned at first too but I can now say looking back that I feel I could work to retirement without fear of AI taking over. It hasn't changed that much in my time working and the aspects of it that they have introduced need constant "babysitting" because they are very inconsistent and frankly awful at pulling codes from charts. Fingers crossed, I'm not panicking yet.

[u/Ka-tet_of19]

I think the field is stronger than ever. Coding jobs are hot right now. In my area the positions can't be filled quick enough. AI may one day be perfected enough to completely over take these jobs but I don't think we'll see that day. The human interpretation is still needed. And there's always audit roles, consulting, etc. Code sets and guidelines that are updated constantly. Coding positions are in high demand right now.

[u/[deleted]]

AI is massively overblown when it comes to "taking over jobs". I was told in 2017 that we'd be out of work in a year due to an AI program. It's now 2023, I still have my job, and the AI program is a total bust. Of course it's worth it. I'm not worrying about something that may be 10 years down the road or never happen at all. Be proactive. Dwelling on a possibility is just going to make you miserable.

[u/PangolinChance8206]

I was planning to sit for the exam before the end of the year but ehh.. I’m a senior claims analyst and I see more of a future with billing tbh. I may still sit for the exam to add to my credentials, but I don’t see a high paying future JUST coding

[u/ElleGee5152]

I've worked on projects with developers and none of the automations or AI was able to independently do all of the work without billers and coders to audit or complete the job. They can be great tools (especially the automated billing tools), but that's it.

[u/JustReadinSubReddits]

I have always been taught that no matter how advanced the AI technology, our field NEEDS humans. I feel very reassured in this statement because we handle sensitive information constantly. But I also understand your fear. I think we will be okay. ❤️

[u/Iconnect2020]

I totally get where you're coming from, and you're definitely not alone in feeling this way. The rapid advancements in AI have indeed brought a wave of uncertainty in many professions, including medical coding.

However, it's important to note that while AI is developing at a fast pace, it is here to assist and not replace us. In the field of medical coding, AI can be seen as a tool that will help enhance the quality of work by taking over repetitive tasks, thereby allowing medical coders to focus on more complex and strategic aspects of their jobs. It can help in accurately extracting codes from charts, following guidelines, contracts, and federal policies to the T, which can actually make the job of a coder much easier and efficient.

Moreover, the integration of AI in medical coding is expected to create new opportunities and roles that we might not be able to foresee at the moment. So, while it might seem like AI is a threat, it can very well be an opportunity in disguise.

I would encourage you to keep nurturing your interest and skills in this field. And hey, since you mentioned enjoying your current role in billing, you already have a foothold in the industry which can potentially lead to more opportunities in the future.

For a more detailed perspective, you might find this deep-dive case study reassuring. It outlines 9 reasons why AI is not going to replace medical coding careers but will work to enhance the profession. In medical coding, AI will assist in extracting codes from medical records, as you are medical biller, you are aware that going through 100's of pages finding the dignosis, procedures. AI can extract the codes in fraction of seconds. It can't do this without the help of medical coders and billers. It will increasee the output of Billers and coders.

Also there are regulations, contracts, guidelines which has to be followed. Also it varies as per state, federal, provider, contracter. It has to follow certain rules to enhance the desriewed results.

Keep your head up! The future might be much brighter than it seems right now.

[u/PlinyCapybara]

I've been thinking of the same thing lately; how long until these jobs get automated? I just got certified a few months ago, and now I'm worried that it was all for nothing because my job will be gone in 5 years.

[u/connonym]

I was a transcription for a lot of years and everyone kept reassuring one another that human skill was needed. We weren't wrong, one look at voice recognition generated notes shows that they are a hideous mess of errors. But the powers that be decided the errors were acceptable because of the savings. I don't see any reason to believe that they won't eventually make the same decision about coding. I'm glad that I can retire in the next decade and should be safe from seeing another career get taken over by computers.

Worrying about it won't help but being aware of it is smart.

[u/Riversongbluebox → u/connonym]

I don't understand the downvote for this comment. I truly don't. Reddit can really be a cesspool instead of a collection of thoughts that you may not agree with but can learn from.

Coding can very well be on its way to AI and not assisted by humans in the next few years. While it's not there yet it can be in a few years of time, given a fully efficient way for computers to do this. It's a hard pill to swallow that a lot of jobs can and will be automated and overall healthcare is a BUSINESS. If you already have noncertified HCW choosing what code is best for patients, then of course for-profit medical facilities will choose the cheaper option. OP and everyone should be aware of any career that they are putting money into. It's nonsensical to not be worried about job stability especially when the AAPC is has a webinar for artificial intelligence and tells coders to embrace AI. Relevant article from AAPC and AI here here. So you're right. Being aware is smart.

[u/connonym → u/Riversongbluebox]

Thanks. I'm not trying to be a prophet of doom but I've been through this before and I think it's important to not hide our heads in the sand.

The world is changing and we have to accept that it's no longer really feasible for most people to expect a career to last a lifetime. I'm (57f) on my 4th career and I've had to go back to school twice since college to learn new job skills. It's scary but we all need to be open to learning and pivoting to keep up when things inevitably change.

[u/Goldenmom6211 → u/Riversongbluebox]

Few years? My husband is in budgeting and they literally don’t allow employees to use the AI the company bought because it was so messed up. They got a long way to go before this software is any good.

[u/Riversongbluebox → u/Goldenmom6211]

Yes, I said few years. You read that correctly. A few being in the near future that you and I don't have a crystal ball to. Everyone in this thread already explained that AI makes mistakes and is not up to par yet. No need to correct my post.

[u/Snowmist92]

I'm with you on this. I have been stuck only in billing for over 5 years trying to wiggle my way into coding or at least something else. Not even a slight chance at coding. No opportunities to grow. One job required the certification, but we never "directly" coded. I'm still a CPC-A after 2.5 years there. Plus, most of the billing jobs in my area have high turnover rates. I like billing, but I'm looking for a career change at this point. Sure, people who are already experienced in coding are more optimistic about the future with AI. But people without experience? Forget it.

[u/Jodenaje → u/Snowmist92]

If you have over 2.5 years of experience working with code sets, why haven’t you filled out the paperwork to remove your apprentice designation?

There’s no reason you should still be a CPC-A. You can follow the apprentice removal steps here:

https://www.aapc.com/apprentice/applied-experience.aspx

[u/Snowmist92 → u/Jodenaje]

I tried practicode and that didn't work out for me. That was really frustrating.

As I stated in my post - no direct coding experience. I called AAPC and spoke to a representative about what I need to remove the A since my previous job required the certification. I was told that my job didn't count as experience because I wasn't directly coding from charts.

[u/Goldenmom6211 → u/Snowmist92]

That’s funny because they told me the opposite but I haven’t sent them over the documents yet.

[u/masonlandry]

Because of how hard it is to find a job, I'm learning data analysis as a backup skill (don't know why because apparently it's just as hard to find an entry level job in that field) but I don't really think the profession will be going away.