Medical coding is a core part of billing, but most physicians don’t think about it much unless there is a problem. Usually, it shows up as delayed payments, denied claims, or billing staff spending extra time fixing mistakes.
In many clinics, coding is done in-house. Sometimes the billing team is small which looks at everything from coding to other stuff. In some cases, one or two people handle coding along with other billing work. This setup can work, but when pressure increases and workloads grow, problems start to show. This happens because patient volume keeps rising, managing multiple tasks becomes difficult, coding rules keep changing, payer requirements differ, documentation is not always clear, and there is very little room for error. As a result, delays and mistakes begin to happen.
Industry studies show that fixing denied claims can take 2-3 times more effort than submitting a clean claim the first time. Even a small mistake like a missing modifier or an incorrect code can delay payment by weeks. Fixing denied claims later usually takes more effort than submitting them correctly in the first place. This is why these days more providers are now looking at AI-assisted medical coding.
Why Manual Coding Overtime Becomes Hard to Manage
Accuracy in manual coding in a practice depends completely on the coder’s experience, knowledge, and the number of coders in the billing team. The work of manual coding starts when coders read clinical notes, decide on the correct codes, and check payer rules before claims are sent. They also double-check that the codes correctly reflect the services and procedures documented for the patient.
As clinics grow, a few problems start showing up. Experienced coders leave, which affects the quality of work and leaves the clinic with fewer coders. Hiring and training new coders is not always easy. With fewer people handling a growing workload, coding often gets rushed. Under pressure, payer rules are missed or applied differently. As a result, claims come back denied and need rework.
These problems are not caused by carelessness. They happen because the volume of work increases faster than the team size. The result is more denials, longer A/R days, and added pressure on billing staff and physicians. A higher number of denials can also increase the risk of external audits.
AI-Assisted Medical Coding
In manual coding, most of the work is done by coders, and accuracy depends heavily on individual experience, knowledge, and effort. Because of this, there is always some room for error. In AI-assisted coding, the work is shared. Repetitive and manual tasks are handled with the help of AI-powered tools that review clinical documentation and suggest diagnosis and procedure codes based on the services provided to the patient. The coder then reviews these suggestions and makes the final decision before adding the codes.
In day-to-day billing, AI goes through clinical notes and other records and points out things that could be missed. It helps find codes that are missing or look incorrect, shows where information is incomplete, and checks payer rules before claims are sent.
This gives the billing team a chance to fix small issues early, before claims go to the payer and get rejected. For physicians, this usually leads to fewer denials, fewer billing problems later, lower A/R, and payments coming in with less delay.
At the same time, using AI on your own is not always simple. Tools cost money, and staff need time to get comfortable using them.Because of this, many providers choose to outsource coding to experienced medical billing companies like Talisman Solutions.
AI in Medical Billing & Coding Services
The main benefit of using AI in medical billing is consistency. It runs the same checks every time and does not slow down when claim volume increases.
When AI is used along with experienced billing staff, clinics usually see fewer coding-related denials, better clean-claim rates, faster payments, and less time spent fixing small mistakes.
At Talisman Solutions, we saw the value of AI early and started using it as part of our medical billing and coding work. AI is used to support our billing team, not replace it. It helps with repetitive checks, data review, and spotting patterns, which allows our team to focus on work that needs experience and judgment.
Coding errors are a common reason for claim denials across the industry. By using AI to review documentation and catch common issues early, we are able to reduce basic mistakes before claims are submitted.
From what we have seen in our own work, AI-assisted coding has helped cut down coding-related rework and follow-ups by around 40–45% compared to a fully manual process. Our billing experts still review claims, talk to payers, and handle complex cases, but with fewer avoidable errors.
For physicians, this results in fewer denials, quicker payments, lower A/R, and a billing process that is easier to manage as the practice grows.
Coding Is Only One Part of Billing
Coding is important, but it is only one part of the medical billing process. Billing issues do not start or end with coding alone. Problems can also happen during claim preparation, submission, or follow-up, and all of these can affect payments.
That is why AI works best when it supports the full billing workflow, not just coding. In our AI medical billing and coding services, AI is used across different stages of billing. It helps with claim scrubbing before submission, charge review, identifying common denial reasons, and prioritising A/R follow-ups.
By using AI across the billing process and combining it with experienced billing professionals, we are able to catch issues early, reduce repeat work, and keep payments moving on time for providers.
Conclusion
Billing affects how smoothly a practice runs, and coding is a big part of it. When coding is done properly, payments come on time. When it’s not, delays, denials, and extra follow-ups start happening.
Doing coding and billing in-house can work at first, but as patient numbers increase and experienced staff leave, it becomes harder to keep the same quality. This is why many physicians decide to outsource coding and billing to experienced providers like Talisman Solutions.
At Talisman Solutions, we use clear billing steps and AI tools in our coding and billing work, which helps us reduce common mistakes, submit better claims, and keep payments more steady for our clients. This allows our clients to spend less time dealing with billing problems and more time focusing on their practice and patients.
