How to choose the Best Medical Coding Outsourcing Company

Medical Coding holds the glue when it comes to making all the pieces of medical billing fall in place. If it is done in the correct fashion, it can help streamline revenue cycle management, boosting revenue in a skyrocketing manner. On the contrary, errors in medical coding can cause reimbursements to take forever, disturbing the financial flow of a healthcare facility. It can cause denied and unprocessed claims to pile up. Owing to this importance, healthcare facilities are leaving this crucial aspect to medical coding outsourcing companies. As the process is highly complicated, it demands to be dealt with by specialists. However, the million-dollar question remains: How do you choose the Best Medical Coding Outsourcing Company? The perfect answer to this question relies on some crucial factors of medical coding. If you are a healthcare provider and are in search of the best medical coding outsourcing company, read this article thoroughly, as it will provide you with comprehensive guidelines in this regard.

1. Determine the Scale of Your Practice's Needs

First and foremost thing, before deciding upon a medical coding company, consider your practice’s specific requirements. Just like medical billing, different coding companies are suitable for different facilities. Depending upon the scale of your practice, you need to make appropriate choices.

a) Small-scale Coding Services

Smaller practices that are comparatively low on budget and have a lower workload should opt for small-scale medical coding outsourcing services. They will give the practice a more personalized sense. A team of coders dedicated to you will always be at your service. They can evaluate your practice in a better way, providing you with accurate coding services. They are also easy on the budget. Small-scale coding services have no or little overhead costs, so the saving trickles down to the clients. Also, they are equally capable as other coders are.
But there is no running from the fact that small-scale coding services might need more resources when handling heavy workloads. They can also require more experience and can be less focused on investing in the much-needed training and ongoing sessions to keep their staff up-to-date.

b) Physician Practice Management Company

Physician Practice Management Companies(PPMCs) are tailor-made for larger practices with staffing over 200. PPMCs are home to accomplished coders who have years of experience in submitting the correct claims. Their expertise lies in solving complex coding dilemmas. They cater to the needs of practices that deal with a large volume of complicated cases. PPMCs also provide dedicated training sessions to the staff to ensure they have a sound grip over what they do and are compliant. They make brisk reimbursements possible, but make sure to negotiate terms so that they resonate with the requirements of your practice.

c) Professional Coding Company

Professional Coding Companies offer in-depth analyses that are a breed of advanced technologies. They harness the power of AI coupled with real-time coding audits to provide unparalleled services. This automation can provide an added sense of accuracy, but all of this comes at a relatively high price. So, before choosing a professional coding company, conduct a comparative analysis of plans offered along with features. Also, look for any additional expenses that might be involved. However, once you procure services from such a company, you can enjoy peace of mind, as they have adequate resources, expertise, and certified coders.

2. Find Companies with Experience in Your Specialty

It is highly advisable to choose a specialty-specific medical coding outsourcing company. This is due to the specialized coders of these companies who are well familiar with a particular medical field. They have the most negligible chances of committing errors. As they have good field knowledge, they ensure a quick turnaround time, fulfilling all the unique coding requirements. It improves the cash flow as the provider receives reimbursement in due time.
Once you outsource services to a specialty-specific coding company, you reduce the administrative burden on your staff, allowing them to focus on their core competencies. These coding experts by employing their specialized knowledge, handle complex cases, plus stay updated on coding guidelines, and ensure compliance with regulations.
For example, in urgent care billing, specific codes are used to reimburse more. This exception is to make for the fact that in these facilities, care is provided urgently without any appointments to tackle non-life-threatening emergencies. In such scenarios, the outsourcing coding companies should be familiar with coding protocols for urgent care facilities. This is where specialty-specific coding pays off.

3. Ask for a Cost Breakdown

Prior to deciding on a medical coding outsourcing company, it is important to take into account that in what manner they would charge you

a) Percentage-based

You will find medical coding outsourcing companies that will charge a chunk of the total net collection. They typically charge somewhere between 3%-9% of your net collections. It means the more revenue your practice generates, the more they get in coding fees. It gives the coding vendors a sense of ownership, and they have extra motivation to go the extra mile to make your practice a success.

b) Flat fee

Most medical outsourcing companies will give you a pricing plan with fixed payments due on a monthly or annual basis. It is a go-to choice for healthcare practices with a long-standing predictable revenue. They can analyze the costs and make informed decisions that are economically feasible for them.

c) Tips for getting the best price for medical coding outsourcing services:

• Quotes: Make sure that you visit 3 to 5 companies before coming to a conclusion. Compare their pricing and the quality of services on offer.
• Negotiate: Never compromise on negotiating before signing a contract. Pricing models of the majority of medical coding outsourcing companies are time-bound. They are open to providing you with discounted prices if you wish to sign a longer-term contract.
• Bundle services: Many companies also have bundle packages. If you wish to procure services such as medical coding and billing, consider bundling them together, as it can help you save money.

Make sure to thoroughly read each quote line by line to ensure that the companies you are comparing are offering the same services. Some companies may charge extra for certain services, such as coding complex cases or staying up-to-date on coding changes.

4. Research Company Reviews

Reputation does make a difference when you are looking for a medical coding outsourcing company. You can search for client reviews on online platforms to determine their performance. The things that you must consider in your search for a good medical coding company includes

• Positive reviews from prior clients.
• Whether the company delivers on its promises.
• Instances of errors resulting in revenue loss.
• You can also ask the company for testimonials or references to further validate their work quality.

5. Software Compatibility in Medical Coding

Practices tend to use internal software for various tasks. If your practice is using one such software, you should choose the medical coding outsourcing company that is using the same software. This is because transitioning to new software can be time-consuming and expensive, and you will face the unavoidable errors as it takes time to adjust to new software. For instance, Flash Code is a user-friendly medical coding software that offers rapid access to coding information. It boasts an extensive collection of ICD-10, CPT, and HCPCS codes, as well as built-in search and filtering tools. If your practice is using it, it will be better that you choose the outsourcing resource in accordance with it. You can also ask the medical outsourcing company if the software training program after signing the contract will be paid or free of cost. Ensuring your staff is OK with the software interface is crucial for a smooth workflow.

6. Medical Coding Compliance

In medical coding, specific codes are used for specific diseases and procedures that are rendered in the form of services by providers. It requires the sharing of the Protected Health Information (PHI) to medical coding outsourcing companies. Prior to doing that you must make sure that

• The outsourcing company has a Business Associate Agreement (BAA) in place with your practice: A BAA is a legal contract that outlines the terms and conditions under which a business associate can access and use PHI. The BAA should be in place before you share any PHI with the outsourcing company.
• The outsourcing company abides by all the applicable HIPAA regulations: HIPAA is a law at federal level that protects the privacy and security of PHI. The outsourcing company must possess robust policies and procedures that implement all the HIPAA regulations.
• The outsourcing company has a secure data storage and transmission system: PHI must be stored and transmitted in a very secure manner in order to protect it against unauthorized access, use, or disclosure. The outsourcing company should have a secure data storage and transmission system.
• The outsourcing company has well-trained and experienced medical coders: Medical coders must be well-trained and experienced in order to accurately code patient encounters. The outsourcing company should have a team of well-trained and experienced medical coders on staff.
• You have a regular audit process in place: You should regularly audit the outsourcing company's work to ensure that they are accurately coding your patient encounters and complying with all HIPAA regulations.

MedsIT Nexus: Best Medical Coding Outsourcing Company

MedsIT Nexus has an established long-standing reputation as an expert medical coding services provider. Our staff, who are driven by a customer-centric approach and are provided with cutting-edge facilities to employ innovation to increase your revenues, is our greatest strength. We believe in providing you with a one-stop solution for all your coding woes, that too at a market-competitive cost. MedsIT Nexus can offer personalized and tailored services that resonate with the objectives and requirements of your services. Also, we strive to stay compliant at all times so that you can rely on us any day of the week.