Benefits of outsourcing and offshoring Medical Coding processes
Outsourcing and offshoring the Medical Coding process can give you access to certified coders, reduce denials, improve reimbursements, and plug revenue leakage. Healthcare providers and revenue cycle aggregators must choose the right service providers to improve the coding quality and achieve market-leading outcomes.
Choosing the right service provider is an essential element of the outsourcing strategy. The strategy can unlock significant benefits for healthcare institutions and give them access to leading-edge technology tools, recover more money, and accelerate the cash flow cycle.
Below are the benefits of outsourcing and offshoring Medical Coding processes:
Scalability and access to ICD-10 Experienced Coders.
ICD 10 refers to the 10th version of the International Classification of Diseases. ICD-10 is the standard transaction code set for diagnostic purposes and the common language for understanding patients’ conditions between payers and providers. The Alpha-numeric format of ICD-10-CM enables healthcare organizations to track billing and reimbursements, understand disease statistics in a population, and improve care quality.
Revenue cycle and coding service providers have established robust processes for recruiting, training, deploying, and certifying medical coders. Industry bodies such as AAPC (The American Academy of Professional Coders) and AHIMA (American Health Insurance Management Association) have set up international branches to assess and certify the skills of medical coders working from offshore locations. Equipped with a rich talent pool of certified medical coders who possess the requisite life sciences or clinical backgrounds and experience, offshore service providers can improve medical coding quality significantly. For all healthcare providers, the ability to enhance first-pass resolution rates is a critical element of their revenue cycle. Better first pass resolution leads to accelerated cash flow, reduced billing errors, and reduced rework on denied claims.Enabling doctors to focus on patient care.
Medical coding has evolved into an exacting science, and accurate coding can avoid costly rework. When the clinicians providing care are also responsible for coding and clinical documentation, they cannot focus on care delivery. They are also not trained to improve coding accuracy and compliance. Third-party services providers like MBW bring in certified medical coders who can improve coding quality and free up the clinician’s time on improving care delivery and patient experience.
Accelerated Cash Flows.
Improved coding accuracy eliminates rework caused by claim denials and improves the first pass resolution rate. The faster cash flow enhances the ability of healthcare institutions to sustain themselves financially. Healthcare RCM service providers operate as per standard operating procedures with service levels for turnaround time and accuracy. The improved compliance to timely filing guidelines is an added benefit.
Improved medical coding and billing compliance.
Medical coding and billing guidelines are not standard across the country. While ICD-10 provides the framework, there are unwritten payer-specific requirements. That’s where the experience of coders comes in. Offshore service providers like MBW invest in documenting the medical coding and billing guidelines thoroughly. These include medical necessity guidelines, compliant use of modifiers, and local coverage determinants (LCDs). Improved coding quality avoids compliance issues caused by up-coding and down-coding.
Cost Efficiency.
Healthcare organizations currently operate against headwinds such as reduced reimbursements, spiraling labor costs, and non-availability of certified labor onshore. On the other hand, different operational areas and technology ecosystems are screaming for investments. Healthcare CFOs are looking to save costs and find ways to find the money to invest in technology and innovation. Outsourcing and offshoring provide ways to unlock savings on labor costs and gain access to new-age technologies such as workflow and robotic process automation. With the service provider giving you these technologies at relatively low costs, there is a shift from fixed to variable costs.
High Security, HIPAA Compliant.
Outsourced revenue cycle service providers invest significantly in information security management systems and assure a secure operating environment for the clients. Information security management system standards such as ISO27001 provide a robust set of controls that ensure security to clients. Often, these controls are more stringent than the controls implemented in your operations. Outsourcing to service providers with these controls assures that they handle PHI and client data with utmost care.
Quality Assurance and Reduction of DNFB.
Healthcare providers who perform medical coding often do not have a robust audit process. The Audit assures high-quality processing and leads you towards increased first pass resolutions. It also helps you uncover missed or unbilled procedures, which improves your revenue. Discharges not fully billed are an area of concern for many healthcare providers, and a robust audit and clinical documentation framework can help you recover more money.
Don’t lose control.
One of the top concerns for healthcare RCM operations leaders is losing control when they outsource. Choose service providers with robust reporting frameworks and client portals to manage daily operational coordination.
As a third-party service provider offering medical coding services, MBW brings the people, the processes, and technology together to help you recover more money in a compliant manner. Our coding services team goes through a structured learning and certification process to ensure that you get high-quality coding at a fraction of the costs you incur onshore.
To learn more about our Medical Coding and audit services CLICK HERE
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