Medical coding is a critical yet complex step within the billing cycle and a top contributor to claim denials. Prioritizing coding accuracy helps healthcare organizations overcome reimbursement delays, reduce backlogs, and promote an optimal patient experience.

Outsourcing medical coding provides a strategic advantage, from cost savings to improved billing efficiency. Healthcare organizations can focus on high-quality patient care while maximizing revenue. 

Understanding Medical Coding 

Medical coding transforms healthcare diagnoses, services, equipment, and procedures into standardized alphanumeric codes. These codes are used universally across the industry to create consistency among healthcare providers, insurance providers, and other entities regarding communication and patient data documentation. They are also used in billing, insurance reimbursement, and medical records.

Medical coding outsourcing involves partnering with an external company, often offshore, that converts patient records into standardized codes to simplify billing and insurance claims. The process involves reviewing inpatient and outpatient procedures, services, and tests to file them for medical recording and billing. Each code created is assigned to a specific process, making accuracy essential.

Key Components of Medical Coding

Physicians use the ICD-10-CM system to classify and code diagnoses, procedures, or symptoms in conjunction with hospital care. CPT and HCPCS codes describe procedures and supplies used. Modifiers are two-digit codes added to these codes that indicate any service modification without changing its definition. For example:

Jane Doe is diagnosed with acute bronchitis and receives a prescription for medication following a chest X-ray to rule out conditions like pneumonia. The ICD-10-CM code for this is J20.9, and the procedure, or CPT code, might be 99213 with the chest X-ray code of 71046.

Medical coding is a complex process and requires extensive oversight — leading many hospitals and medical practices to explore outsourcing options. Having well-versed experts who can code charts quickly while delivering consistently accurate results, is a strategic way to simplify your revenue cycle.

7 Benefits of Outsourced Medical Coding Services

The high demand for proficient coders and the continuously evolving nature of medical codes make outsourcing an increasingly popular option for healthcare organizations across the country. Partnering with a specialized coding firm allows you to streamline operations, improve financial performance, and ensure compliance.

1. Cost Effective
2. Faster Turnaround
3. Fewer Medical Billing Errors
4. Ongoing Education and Expertise
5. Scalable and Flexible
6. Consistency and Transparency
7. Security and Compliance

1. Cost Effective

Outsourcing reduces the need to hire, train, and maintain an in-house coding team. Hiring internally increases labor costs and time spent managing staff turnover. Meanwhile, outsourcing reduces overhead such as insurance, retirement, supplemental pay, and other required government benefits. It also saves on new infrastructure and equipment expenses. US-based healthcare organizations can reduce coding operating costs by an average of 75% when working with offshore billing firms. 

2. Faster Turnaround

International outsourced teams offer a unique “time-zone advantage.” When US-based healthcare offices are wrapping up their day, it's morning for most international teams. Claims that have just been submitted are worked on immediately, often resulting in 24-hour turnaround times or less. Quicker processing times will speed up billing and payment cycles and accelerate reimbursement. 

3. Fewer Medical Billing Errors

Forty-two percent of all denials are caused by coding mistakes. Experienced outsourcing firms have teams of certified coders extensively trained on the latest coding standards, and performance is audited regularly. Increased accuracy improves productivity and minimizes payment delays. Combined with dedicated A/R follow-up personnel, your organization can recover more payments while closing out any delinquent accounts.

4. Ongoing Education and Expertise

Medical coding demands attention to detail, understanding specialty nuances, and staying ahead of annual updates and changes. Outsourcing firms invest extensive time and resources into continual training and preparing coders for the complexities of more difficult coding specialties such as cardiology, home health, and oncology.

5. Scalable and Flexible

Hiring, training, and managing turnover requires tremendous time and financial investments. Outsourcing provides healthcare organizations with a sustainable staffing solution. Outsourcing firms have a close pulse on hiring trends and are always recruiting and training new talent in anticipation of forecasted attrition. Eliminating the burden of finding quality coders allows organizations to scale and focus on growth goals. 

6. Consistency and Transparency

A dedicated coding partner performs thorough audits and provides daily/weekly/monthly reporting. Consistent process oversight allows healthcare organizations to address and remedy problem areas quickly. A reputable coding partner has rigorous quality assurance measures that lead to consistent service levels and the achievement of industry key performance indicators (KPIs). 

7. Security and Compliance

The importance of protecting patient data cannot be overstated and compliance and regulatory rules are constantly being updated. HIPAA-compliant outsourcing firms with HITRUST and SOC2 Type2 certifications provide peace of mind for healthcare organizations struggling to stay ahead of ongoing regulatory changes and data threats.

Trust Global Healthcare Resource for Your Medical Coding Outsourcing

Outsourcing your medical coding allows your team to focus on patient care while reducing overhead, minimizing errors, and improving your revenue cycle management's efficiency. The flexibility and scalability of outsourcing allows your organization to quickly adapt to changing demands while counting on improved turnaround times and better financial outcomes.

At Global, our medical coders follow the strict ICD-10, CPT, DRG, and HCPCS guidelines to ensure everything is coded correctly. We use both in-house and external compliance experts to audit the process, helping us maintain nearly perfect accuracy rates. By partnering with us, you have quicker turnaround times and access to premium coding resources that might not be available in your area. We have over 6,000 HIPAA-compliant coders, call center agents, and billing professionals and a track record spanning over 25 years.

Schedule a free consultation with Global's coding specialists to learn more about how you can improve your current medical coding process.