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blog November 01, 2023

Pros & Cons of Outsourcing your Medical Coding

Woman looking at medical coding spreadsheet on computer
Woman looking at medical coding spreadsheet on computer

As of April 2023, there was a 30% shortage of medical coding professionals. With fewer knowledgeable personnel, and insurance companies designating over 180,000 medical codes required to process claims, errors are often the result. Coding medical procedures incorrectly, causes frustration with patients, lost time, compliance concerns, and decreased revenue for healthcare providers.  

Estimates suggest that doctors themselves are spending up to 46% of their time on coding. Not only does this take away time doctors spend with their patients, but RevCycleIntelligence reports that 4 out of 10 consumers describe frustration with inaccurate billing or procedures that were coded incorrectly. Whether caused by a lack of staffing or the complicated process, never before has ensuring accurate coding been more valuable. 

Whether you have 100 or 10,000 patients, find a business partner equipped to optimize your reimbursements at any size. Outsourcing medical coding to a partner can assist in reducing denials resulting from inaccurate coding plus provide insights into where your office’s staff may have workflow gaps, accuracy issues, and compliance concerns, preventing missed revenue opportunities. By reducing administrative burdens and improving coding accuracy, healthcare offices are free to focus on patient care and improving the patient experience. 

doctors spend 46% of their time on medical coding

Flexibility to scale 

With insights from medical coding experts, your business enjoys the flexibility to scale and grow. Embracing a medical coding partner, empowers your practice to add clinicians, expand services, or add offices knowing that you have the flexibility to ramp up coding needs quickly without the heavy costs of hiring and training new staff members. 

Flexibility is also provided to accomodate seasonal changes typically seen in healthcare, such as end-of-year deductible requirements, flexible spending opportunities, back-to-school vaccines, and wellness checks. Whether by adding more offices or skillfully handling the upsurge of patient appointments, outsourcing medical coding provides flexibility to the ever-changing needs of your practice.  

Prevent revenue leakage and gain financial wellness 

A skilled business partner identifies possible redundancies and conforms the work to ever-changing regulations. These minor nuances detect trending denials. An outsourced medical coding partner streamlines daily coding activities into a more manageable, less stressful, and less burdensome event; consequently, a practice’s income increases. 

Further, financial wellness develops when the healthcare technology partner embodies the role of medical coding supervisor. The outsourcing partner lifts the load on existing healthcare employees as some personnel might handle competing job duties. Through workload reduction and a concentration on one assigned role, the revenue management partner helps alleviate employee burnout and address revenue leakage These areas are often mired in compliance concerns. 

Medical offices may sacrifice patient care to pour through medical coding paperwork and hit Key Performance Indicators (KPIs). By outsourcing, you closely monitor days in accounts receivable, missing charges, high volume of superbills, clean claims rates, pre-authorizations, and denials. Let a billing expert proactively uncover areas of concern.  

Quality assurance: Experts for your particular specialty 

Haphazard coding denies a healthcare professional’s success. Unfortunately, medical coding is frequently tackled as a one-size-fits-all approach in a busy practice. Greenway Health cultivates partnerships with their clients to optimize coding for a particular specialty from areas such as OB-GYN, pediatrics, primary care, cardiology, or podiatry.  

For instance, health solution experts confer cardiology procedures as one of the most difficult coding areas. This specialty needs a highly skilled coder.  Experts on a medical coding team, such as Greenway, render turnaround times of 48 hours and ensure that 5-10% of charts are randomly selected for quality assurance. Medical coding expertise directs your office workflow, pinpoints revenue, and saves time. 

Many billing companies employ assisted technology (AI) or automation without fail-safes to catch potential errors. They rely heavily on the use of AI or automation. While automation may provide faster iteration and processing, it is still vital to use quality control measures. That trusted business coding partner must ensure accuracy through auditing and quality assurance. For stability, look for a company with 100% compliant regulations with HIPAA/HITECH and a high rating of a three-tier quality assurance process. Certified, HIPAA-compliant consultants stay up-to-date on changes. This nimble approach affords the office less worry and better compliance with areas such as ICD-10 coding. 

Guardian for success 

Streamlining billing procedures or identifying improper coding can help result in better overall KPIs for your practice. A trusted medical coding partner acts as your protector and defender against coding errors from unbundling or invalid codes. The software from an IT tech leader updates constantly for state-of-art and worry-free compliance.  

Go with an industry leader who earns feedback directly from healthcare providers. Find a leader in healthcare technology already backed by high satisfaction in revenue cycle management within KLAS ratings. 

Ready to elevate your medical coding and billing?  

CONTACT US

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