In today’s increasingly complex healthcare environment, healthcare organizations’ medical coding can be a daunting task. Handling it in-house can be time consuming and expensive, as it requires highly trained staff with the expertise and resources to achieve high levels of accuracy, speed, and consistency. That is why many healthcare organizations are turning to outsourcing for their medical coding services and revenue cycle management. In this article, we will discuss the top reasons why healthcare organizations should outsource their medical coding services.
Medical coding is a complex and detail-oriented process that has different regulations and rules across various states. Although ICD-10 offers the required framework, different payors have various unstated and often evolving needs that only an experienced and up-to-date coder will be able to meet. Clean claims help in improving your company’s bottom line. At Red Road, we have a systematic approach to medical coding and billing that helps us achieve an average accuracy rate of 98%. We take care of the modifier compliances and local coverage determinants (LCDs). Our highly trained team is adept at avoiding the common medical coding errors that lead to incorrect billing, claim denials, and other issues.
Outsourcing medical coding services can be more cost-effective than hiring and maintaining an in-house team. Medical coders are expensive to hire, as they are required to have special training and are an in-demand position. By outsourcing, you can tap into a pool of well-trained professionals at a much lower cost.
According to AAPC, the average salary of a medical coder is around $52000 and the salary for certified medical coders is much higher.
Outsourced medical billing teams work with experienced and qualified billers capable of handling a range of medical claims. Rigorous training, continuous process improvement, and a drive to achieve accuracy help in mitigating billing errors before claims submission, thereby reducing the rejection rates.
Medical coding is subject to various regulations and compliance requirements, such as HIPAA, ICD-10, and CPT codes. Companies dedicated to medical coding and other clinical back-office support services make large investments to protect clients’ data, which are stricter than the standards of many individual healthcare organization. Patient Health Information (PHI) and Personal Identifiable Information (PII), as well as other sensitive information, are highly safeguarded and healthcare organizations can be assured of the highest level of data security. Additionally, they are up-to-date with regulations and can help providers ensure that they remain compliant.
Having an in-house team of RCM staff and medical coders requires an investment of time and resources to recruit, hire, train, and retain the staff. By outsourcing the entire revenue cycle management process, providers can reduce these overhead expenses. Furthermore, an efficient and effective outsourced team with expert coders will help maximize your revenue with clean claims, and reduced denials.
Outsourcing medical coding services allows healthcare providers to scale their coding needs up or down depending on demand. This can be particularly beneficial during seasonal fluctuations in patient volume.
Process audits are conducted at every stage of the billing and coding process to ensure high-quality. These audits help in ensuring that no information is missed out from the patient treatment plans and that health records are checked for both legibility and completeness of information before coding. Secondary audits after coding are done with a checklist to ensure every piece of information is filled in before submission. And finally, after the bill’s claims have been processed, the records are compared and checked for payment completeness.
Experienced and reliable medical coding teams keep thorough records and will share timely reports of your healthcare facilities’ performances. You will have access to all the necessary insights into your organization’s revenue. These reports will serve to supplement any internal records you maintain, as the outsourced team will be highly meticulous and transparent. Think of it as an added advantage to your organization.
As a high-performing extended team for your healthcare organization, Red Road provides expert clinical back-end services to improve your business efficiency and to grow your profitability. We are committed to delivering high-quality, truly responsive solutions in a cost-effective manner.
Whether it’s home health medical coding services, clinical compliance reviews, or revenue cycle management, you get the highest standards of service at significant cost savings for your organization, eliminating the unnecessary and costly barriers (middle-men) to working directly with your clinical back office support solutions provider.