Your healthcare organization’s compensation relies on accurate and efficient medical coding and the submission of medical claims. Medical coding, however, can be complex, time-consuming and expensive when you complete it in-house. These challenges lead many practices to consider medical billing and coding outsourcing.
Deciding whether to build an in-house medical coding team or outsource your coding to a third-party coding specialist is an important decision for any healthcare organization. In most cases, working with outside coding professionals is the optimal option because of the advantages this approach provides. Here’s why you should consider medical coding outsourcing.
- Up-to-Date Certifications
- Consistent Staffing Levels
- Hiring Challenges
- More Time for Core Activities
- Flexibility and Scalability
- Consistent Quality and Accuracy
- Security and Compliance
What Is Remote or Outsourced Medical Coding?
When you outsource your medical coding, you contract your coding work out to a third-party coding company instead of completing it in-house. Depending on your agreement, the coding company will be responsible for all or most of the work related to your medical coding needs. The third-party company is also responsible for keeping their staff up-to-date on the latest coding skills and requirements. While many medical coders work remotely, you can also contract with coders who will come into your practice and work there.
If outsourcing their coding, after completing a procedure, a physician will send the medical charts over to the company they work with. The coders will read the charts, complete the coding and send the charts back to the practice.
Outsourced medical coding agencies may also perform medical coding audits and provide other services such as medical record review, research support and clinical documentation improvement.
The alternative to outsourcing your medical coding is to complete it in-house. At some organizations, the physicians and other medical professionals may do coding themselves. Other organizations may build an in-house team of medical coders to complete all or most of their coding.
Benefits of Outsourcing Medical Coding
There are many advantages to outsourcing your medical coding to a specialist. Here are some of the leading reasons outsource medical coding is the right choice.
1. Up-to-Date Certifications
Medical coders need to keep up with updates to coding systems, regulations and best practices. They also need to stay current with certifications and complete continuing education requirements. It’s also beneficial for them to keep up with updates from government agencies, healthcare organizations and other groups through their websites, blogs, email lists, webinars, seminars and other resources.
Keeping up with certifications and updates requires a significant time investment. Occasionally, a major update will occur that creates a substantial change in medical coding. The introduction of ICD 10, for example, brought with it a significant increase in the number of codes. ICD-10-PCS has about 19 times more procedure codes than ICD-9-CM, volume 3, and ICD-10-CM has about five times more diagnosis codes than ICD-9-CM.
If you work with third-party medical coding specialists, you don’t have to worry about these requirements, however. Medical coding outsourcing companies will take care of these issues for you, and you can rest assured that the coders working on your charts are up-to-date with their certifications, skills and knowledge.
At HealthCare Resolution Services (HCRS), our coders are all fully certified by the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA).
2. Consistent Staffing Levels
If you have an in-house coding team, you rely on them for all of your coding needs. When you have only your team to work with, you have limited adaptability to adjust to changing conditions. Sometimes the volume of coding that needs to get done may exceed the capacity of your in-house team. Other times, your team may be short-staffed because one of your coders is on vacation, gets sick or even quits. This can lead to backlogs in coding work and delays in payment.
Medical coding agencies, on the other hand, have a large staff of coders, so they can adjust to changes in the volume of work your practice gives them. They also don’t have to worry about one of their workers being out of the office, because they have other coders they can rotate in. When you work with contract medical coding companies, you can be comfortable knowing there are always enough coders to get the job done promptly.
In many cases, outsourcing your medical coding works out to be more cost-effective than hiring and maintaining an in-house team of coders. Employing medical coders, especially ones with specializations and superior skills, is expensive. With outsourcing, you get access to top-notch coders at a lower rate.
According to the AAPC, the average salary for a medical coder is $52,411 annually. Certified coders and those with more experience will command a higher salary. Coders who specialize and have certifications as a Certified Professional Medical Auditor, Certified Documentation Expert Outpatient or Certified Physician Practice Manager earn an average of around $64,000 annually.
Salary isn’t the cost associated with employing a medical coder, of course. You will have other expenses such as employer-paid taxes and benefits like health insurance, retirement benefits and paid time off. These costs will be about 35 percent of a coder’s salary. You will also have expenses such as office space and supplies as well as intangible costs like those associated with hiring, training, supervising, licensing and insurance. You also need to consider the opportunity costs for the time you’ll spend hiring, training, managing and otherwise investing in your internal coding team.
When you outsource your medical coding, the company you contract with is responsible for all of these expenses. Because they operate on a larger scale, have experience with medical coding and have coding as their primary focus, they can typically provide these services to practices for less than it would cost the practices to conduct all medical coding themselves.
Because conditions differ between practices, you can conduct your own analysis to determine what the most cost-effective option is for you. Often, the most economical approach is to outsource your coding to a specialist.
4. Hiring Challenges
Hiring medical coders can present challenges beyond costs. There is currently a shortage of qualified medical coders. This is due in part to the IDC 10, which reduced coders’ productivity due to the need to learn a new system. The introduction of ICD 10 also led to large-scale retirements, and more retirements are expected shortly, as the average age of a medical coder is 54.
It’s even more difficult to find a qualified coder if you need one with experience in a particular specialty. There may not be enough medical coders in your area who meet your requirements. The medical coder shortage is also driving up the salaries of coders. Retaining the coders you hire can also be a challenge, especially since there are so many job opportunities for coders today.
If you outsource your coding, however, you will constantly have a pool of coders available. Even if some coders leave the company you contract with, they will have others to take their place immediately. Remote medical billing and coding companies can hire coders from anywhere, so they have a larger pool from which to hire employees. The coding company you work with will have coders available who have the qualifications you need, even if you need someone with a specific specialization.
5. More Time for Core Activities
Doing medical coding in-house takes time and resources away from other activities. This is especially apparent if physicians do their own coding, but training and managing an in-house team takes significant time and resources as well. There’s a considerable opportunity cost associated with doing your own medical coding.
Outsourcing your coding gives you more time to focus on core activities. This means that your staff has more time to focus on patients, helping to improve quality of care. When you work with a reliable coding company, you’ll still get accurate coding and get compensated in a timely manner, but you won’t have to take time away from the core of your practice to get those results.
6. Flexibility and Scalability
Working with a contract medical coding company affords you more flexibility and scalability than hiring an in-house team does. With an internal team, you have a set number of coders. Hiring additional employees is a long process. Those coders also have limited expertise and experience, so if something unexpected happens, they may not know how to deal with it without additional training.
With outsourcing, however, you have access to a large pool of coding professionals. This access enables you to scale your team up or down almost immediately. If you have an unusually high volume of work one day, the coding company can assign more employees to complete that work so you don’t have a delay in submitting claims and receiving payments. As your practice grows in the long run, you can also scale up your coding capacity more permanently with minimal effort.
You also have access to coders with different expertise and certifications if you use outsourced medical coding companies. If you need coding for a specialized medical service you don’t normally deal with, the company will have a coder on staff with the knowledge necessary to meet that need.
7. Consistent Quality and Accuracy
When you work with a coding specialist such as HCRS, you know you’re getting services that provide a consistent level of quality and accuracy. We have years of experience with medical coding and a large team of skilled coders. We code and audit more than 3 million medical records every year for the Army, Navy and Air Force, and we consistently have accuracy rates of 95 percent or more.
Because of the flexibility that a medical coding outsourcing company can offer, you can be confident that you’ll get the same level of quality even if the volume of records increases. You also don’t have to worry about decreasing levels of accuracy and quality due to lower levels of staff on certain days or changes in coding rules.
The coding company you work with will be able to provide you with detailed records and performance reports related to your medical billing. They may provide you with these reports automatically or upon request. This gives you excellent visibility into your coding and billing, helping you to get a more complete picture of how your practice operates. You can obtain these insights without having to invest time in keeping and maintaining detailed records or even supervising staff. This advantage is another point you should consider when deciding whether to hire or outsource medical coding professionals.
9. Security and Compliance
Security and compliance with regulation is a significant concern for all healthcare organizations. In regards to medical coding and billing, you need to have robust data security and disaster recovery measures in place to protect against data loss and other cyber incidents. You also need to ensure compliance with HIPAA and other regulations.
A professional coding firm will understand the security and compliance concerns related to your coding needs. While you should always take proper precautions on your end, you can be confident that your coding company is taking the proper steps as well.
Partnering With HealthCare Resolution Services
If you’re looking to improve the accuracy, timeliness and consistency of your medical coding and billing, consider outsourcing your coding. This approach provides numerous benefits that make it a smart choice for many healthcare organizations.
HealthCare Resolution Services is a leading medical coding company with more than 20 years of experience working with some of the country’s largest healthcare providers including governmental, military, veteran and civilian organizations. We have a large staff of certified, skilled coders, and we’re ready to provide the quality medical coding services you need.
All of our coders are certified by the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) and have at least three years of experience. Our coders use our proprietary coding software to achieve improvements in accuracy and efficiency. We offer affordable rates for remote U.S., offshore and on-site services.
We deliver concrete improvements in coding productivity, efficiency and accuracy. We increased monthly coding productivity by 48 percent, increased monthly audited record by 122 percent and reduced overall administration time from 31 to four percent for the U.S. Navy Headquarters Bureau of Medicine and Surgery (BUMED). When working with the Medicaid Integrity Program (MIC), we helped to recover more than $40 million in improper payments. We work with more than 300 military treatment facilities.
We’ve also delivered more than 6,000 training hours in evaluation and management coding, audit preparation and more. We offer abstraction and quality management, auditing, medical record review and research support services.
We have a full suite of services to help our clients handle the workload threatening to overwhelm healthcare providers and government health agencies. To learn more about our medical coding services, contact us by filling out this quick online form or give us a call at (866) 599-4277.