Are you facing backlog associated with:
- growing lag days
- Discharged Not Final-Billed (DNFB)
- Electronic Health Records (EHR) conversion
- expanding service lines, or
- geographic obstacles preventing you from quality coding resources
An outsourced partnership could be the perfect solution.
Certified coders were a newly emerging concept when I began in the industry. Their value was not clearly evident. As a medical billing specialist, it was my job to review denials and get claims paid. On more than one occasion, I heard a physician or an administrator ask, “Why should I pay someone to review these charges when I am going to get paid the same amount either way?”
Fast forward to a time when the Offices of Inspector General (OIG) are on the front lines of healthcare investigating allegations of wrongdoing. Recovery Audit Contractors (RAC) are continuing to extend their review of Medicare and Medicaid claims, both for over-payment and underpayment, collecting a commission only when they find fault. Scrutiny is at an all-time high. With the transition to the upcoming “pay-for-performance” healthcare model (MACRA) on the horizon, it’s more important than ever to mitigate risks associated with non-compliant claims while capturing all supported services.
Benefits of a successful medical coding outsourcing partnership
- 100% AHIMA and/or AAPC Certified staff and HIM leadership
- HIPAA compliant
- quality-driven coding based on the 95% industry standard benchmark or higher
- robust initial quality assurance process followed by monthly coder audits
- production-forward process with reportable data
- maximized compliance with state and federal guidelines, minimized denial management time
- reduced training costs
- dedicated management of the outsourced coding team; complimenting your existing resources rather than adding to your administrative oversight
- minimized overhead costs associated with additional IT and/or facility resources
- access to experienced coders knowledgeable in major specialty services and the EHR systems
- customized solutions that are specific to your changing needs
It can be hard to ask for help, especially from an outside team, but leaving valuable revenue on the table is simply not an option. Having access to an experienced HIM coding team that keeps pace with ever-changing state and federal guidelines is critical to success.
About the Author
DIRECTOR OF PROFESSIONAL FEE CODING FOR HEALTHCARE RESOURCE GROUP, INC.
Teresa Tate, CPC has over 16 years of coding, auditing and provider education experience. As the Director of Professional Fee Coding at HRG, Teresa and the HIM department are constantly coming up with solutions to the unique problems facing pro fee coding. Teresa, a true educator, is always willing to share her knowledge and experience to forward advancements in coding and the health services industry.