The Top 10 Reasons Why You Should Outsource Your Medical Coding
As ICD-10 implementation draws near, the shortage of qualified medical coders will only become more acute. Outsourcing your medical coding is a solution that fits the needs of large hospital groups, standalone hospitals, large and small physician groups, and other healthcare organizations. It can result in zero coding backlogs, guaranteed quality, reduced cost, and no worries about coding resources or shortage-driven cost increases.
Below, we offer you the top 10 reasons why outsourcing makes sense for your organization.
1) Scalability
Recent estimates suggest the United States currently has 30 percent fewer medical coders than needed. Combine this shortage with the productivity losses created by ICD-10, and the result is a perfect storm of lost time and revenue, as well as denied claims due to incomplete or inaccurate coding.
Outsourcing to a team of highly experienced medical coders—those who understand ICD-9 and ICD-10 coding guidelines (as well as the coding platforms)—benefits coding managers in multiple ways. First, it enables them to support existing staff, reducing their workload. It also provides training, encouraging new professionals to join the field of medical coding.
In addition, with the abundance of offshore medical coders, this solution can fit the needs of large hospital groups, standalone hospitals, large and small physician groups, and other healthcare organizations.
At Ovation RCS, we have a staff of over 2,000 medical coders who have experience with nearly 100 market leading software platforms. This includes EPIC, GE Centricity, AdvancedMD, Medical Manager, NextGen, Kareo, and many other mainstream proprietary platforms. This breadth of experience enables our coders to quickly and seamlessly replicate client-specific processes.
2) Highly Educated Coding Workforce
Since ICD-9 to ICD-10 conversion expands coding systems from 17,000 codes to more than 140,000, there is a significant learning curve for experienced medical coders. This is also a possible deterrent for new professionals entering the field of medical coding. Medical coders must learn a more detailed, in-depth coding process in order to handle the increased precision required to closely reflect the assessment and treatment associated with the clinical picture. Medical coding and reimbursement are directly impacted by the medical coder’s ability to apply their fundamental knowledge of anatomy and physiology to the clinical picture represented in the record.
The average overseas medical coder is often an experienced healthcare professional with extensive medical knowledge and a clinical background that includes anatomy, physiology, disease process, and ICD-10 coding.
At OvationRCS, over 70% of our coders have a Master of Science Degree in Microbiology, Physiotherapy, or other life sciences subjects. Ongoing coder education that strengthens coding skills and enhances knowledge of clinical indicators is a core staff development principle. Medical coders assigned to a facility have in-depth experience with multiple physician specialties including emergency medicine, radiology, pathology, anesthesia, cardiology, internal medicine and many more.
3) Cost Saving
Providers incur significant expense to assure their medical records are coded according to the ICD-9 coding guidelines that include more than 17,000 codes. The planned expansion of ICD-10 coding guidelines (which include more than 140,000 codes) promises to reduce coder productivity while requiring more coders to process the same number of medical records. The existing medical coder shortage will most certainly grow as the demand increases.
Increasingly, providers are searching for external partners in preparation for ICD-10 coding guidelines. In a recent survey by market research firm Black Book Rankings, nearly half of the 650 hospitals polled indicated that they will outsource ICD-10 services when the new diagnostic and coding system goes online next year. The survey also found that 19% of providers are outsourcing medical coding already, and that number is anticipated to grow to 47%.
Outsourcing to offshore coding brings a cost effective alternative to the coder shortage. In addition to the readily available and highly educated workforce, offshore coders cost about half the price of domestic coders. Outsource coding is a cost savings strategy that will enable providers to incorporate a larger workforce to perform medical coding functions.
4) High Security, HIPAA Compliant
While outsourced coding is a resource available to coding managers; (that can eliminate coding backlog by utilizing a highly educated, cost-effective workforce), very real concerns about data security may cause hesitation. Complete confidence in information security, HIPAA Compliance, and Disaster Recovery is essential to coding managers and is necessary in order to enable their ability to outsource a portion of their services.
We share these concerns and have taken steps to assure a secure information environment. Our Ovation RCS coding partner maintains process and security certification in ISO 9001 and ISO 27001 while also complying with SSAE 16 Type 2 standards as well as all HIPAA regulations. State-of-the-art infrastructure delivers value through dedicated Internet linkage, multi-contact capabilities (including Voice, Web Chat, E-mail and Fax on Demand) and sophisticated call handling capabilities. The disaster recovery strategy and multiple processing centers give us the unique ability to always maintain uninterrupted operations.
Our commitment to quality standards and information security is evidenced by the infrastructure in place to assure uninterrupted service in a secure information environment.
5) ICD-10 Experienced Coders
With changes in U.S. healthcare resulting in increasing costs – costs of medical insurance, changing coverage restrictions and allowances – as well as the revised ICD-10 codes, healthcare providers are rightfully concerned about the quality and accuracy of medical coding.
Ovation RCS has taken a proactive approach to assuring our medical coders are proficient in ICD-10 coding guidelines. Our approach to preparedness includes developing a training infrastructure that teaches ICD-10 coding guidelines to current and future coders, as well as on-going training, practice, monitoring, and feedback to assure our high-quality expectations are met. Our coders have extensive medical record coding, HIPAA, and LMRP compliance training or review that assures retained accuracy standards. In addition, our medical coding quality assurance team monitors ongoing coder accuracy.
Our coding operations team codes more than 230,000 records per month, (following ICD-10 guidelines), in support of a client’s dual-coding initiatives. The specific coder preparedness initiative is developed in collaboration with the client. It allows sufficient practice and leads to proficiency in medical coding according to the new guidelines. Individual coder quality is monitored closely, and improvement initiatives are developed to assure coder proficiency within ICD-10 requirements.
At the core of the Ovation RCS Coding service is the dedication to quality and the understanding of how these codes relate to reimbursement and claims payment.
6) Accelerate Cash Flow
Recent estimates suggest the United States currently has 30 percent fewer medical coders than needed. Combine this shortage with the productivity losses created by ICD-10, and the result is a ‘perfect storm’of lost time and revenue, as well as denied claims due to incomplete or inaccurate coding.
Complete and accurate medical coding requires the coder to be thoughtful and take the time to thoroughly review the record and coding guidelines as necessary to assure the coding captures all services provided. Conversion from current ICD-9 to the upcoming ICD-10 coding system (expected to take place in October 2015) leaves providers in a costly position. A backlog of medical records needing to be coded may result in less revenue as the coders are caught between the goal of complete and accurate coding, the need to reduce the backlog, and the expectation to learn the new ICD-10 coding guidelines at the same time.
Multiple coding sites enable us to code while you sleep. With our help, your organization essentially codes 24 hours a day. Our outsourced coding teams code overnight while your on-site medical staff codes during regular business hours. With our extensive network of highly-trained medical coders, we can provide you with cost-effective coding resources to ensure accurate and prompt payment. Our goal is to improve the bottom line for our customers. Your success is our success.
With an abundance of medical coders, outsource coding with Ovation RCS is a solution that fits the needs of large hospital groups, standalone hospitals, large and small physician groups, and other healthcare organizations. It can result in zero coding backlogs, guaranteed quality, reduced cost, and no worries about coding resources or shortage-driven cost increases.
7) Lean Six Sigma Principles
Lean Six Sigma is a process improvement methodology with a focus on removing waste. Lean Six Sigma methodology relies on a collaborative team effort to identify waste and improve efficiency. Waste in medical coding is commonly described by terms such as incomplete, inaccurate, and a backlog of accounts waiting to be coded. These inefficiencies are eliminated by the collaborative team approach to applying Lean Six Sigma principles that focus on the gap between performance and expectation.
A focus on process through Lean Six Sigma methodologies (including data-driven improvement initiatives and standardized processes designed to ‘get it right the first time’) assures medical coders achieve high-quality performance that results in high accuracy and rapid turn-around time.
Our coding operations staff is rigorously trained and tested prior to being assigned to a customer. We conduct concurrent and retrospective review of accounts, and direct improvement initiatives at the systems, processes and individual coders to address gaps in knowledge and/or performance. We also analyze workflow and outcomes while implementing continuous performance improvement initiatives to assure best practices are incorporated into the culture overall and at the individual level.
Six Sigma Black Belt project managers assimilate collaborative teams consisting of coders, coding specialists, coding auditors and managers at all levels to drive rapid improvement initiatives. Ovation’s dedication to Lean Six Sigma principles assures timely, accurate, and complete medical coding (as reflected by a greater than 95% accuracy) with a two-day turn-around time.
8) Dedicated Team of Medical Coders
We assign our customers a dedicated medical coding team to assure that, in addition to fundamental coding knowledge (reading medical records and applying coding guidelines), they learn and apply customer-specific guidelines and procedures developed by the coding manager for implementation in his or her facility. Communication is directed to assigned team leaders who facilitate rapid dissemination of new information and issue resolution.
Our dedicated team of medical coders quickly become familiar with the facility’s coding processes, services and associated providers. The assigned coding operations team works very closely with the customer to ensure our processes and performances achieve their high-quality coding expectations.
9) Global Coding Academy for Medical Coding Certification
With the changes in the U.S. healthcare due to increasing costs – cost of medical insurance, changing coverage restrictions and allowances, and the revised ICD-10 codes – more and more healthcare providers need additional qualified individuals to provide medical coding services that get claims paid in a timely manner. Payers are applying increased scrutiny to their billing practices and reimbursements and providers are absorbing the costs.
The payers are analyzing all medical documentation to ensure patients are receiving the appropriate level of care at the correct cost. Medical coding denotes the surgical, equipment or diagnostic service provided. Connecting the correct, valid medical code to a qualifying diagnosis ensures that charges will be reimbursable—instead of denied and unpaid. Poor documentation and incorrect coding invariably lead to denials and delays of payment, which are the pain of any provider.
The Coding Academy trains new employees on all aspects of the coding field. Ongoing education is also provided to ensure coders are knowledgeable about new technologies and can access updated coding guidance (which is published in the Coding Clinic). This education will help providers avoid claim denials and possible lengthy appeals processes.
At the core of the Coding Academy is the importance of accurate coding. There are 14,025 diagnosis codes and 3,824 procedure codes in ICD-9-CM. In ICD-10, there are 69,823 diagnosis codes and 71,924 procedure codes. Ovation RCS strives to educate staff on correct code assignment of all diagnosis and procedure codes in both ICD-9 and ICD-10.
Another core value of the Ovation RCS Coding Academy is the introduction and establishment of the importance of implementing a Lean Six Sigma process improvement methodology in business strategy. Lean Six Sigma process improvement methodology not only assures Ovation RCS medical coding quality, it also empowers the learner to apply this strategy to their business.
10) Friendly, Customer-Oriented, US-Based Coding Company with Provider-Proven Results
Ovation RCS is both provider-tested and proven to closely monitor and assure policies, security, and operations for high-quality performance. Outcomes have shown — outsourced medical coding provides a cost-effective, yet first-rate coding resource. As managers struggle to meet the challenges of ICD-10 implementation, a coding backlog makes those challenges even more urgent to conquer. Outsourced coding promotes a reduction in coding backlog and accelerates cash flow. Outsourced coding also makes the initiation of staff education programs by coding managers possible, without the fear of developing a coding backlog.
This dedication to medical coding quality enables Ovation RCS customers the opportunity to continue to choose, with confidence, Ovation RCS Outsourced Coding that complements their coding efforts.
To learn more about Ovation Revenue Cycle Services’ Comprehensive Coding Services, visit www.ovationrcs.com.
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