As the healthcare industry continues to grow, so too does the demand for medical coding. According to Grandview Research, the US medical coding market was valued at $17.9 billion in 2021 and is expected to have a compound annual growth rate of 8% from 2022 to 2030. Due to medical coding being a complex task coupled with its exponential growth, many organizations consider using medical coding solutions. Accurate coding is vital for healthcare providers to receive timely reimbursements and process claims efficiently.
Medical coding solutions include outsourcing to a medical coding service, an external company that helps with coding tasks. These solutions are often varied and customizable, depending on the medical coding service picked. The provider may work with a company that takes all the medical coding to an external location. Another scenario is that the provider may use the company to supplement their own in-house team. Finally, the provider may select a company that works in-house with their team. There are many options when it comes to outsourcing and looking for a medical coding solution.
When to Look for Medical Coding Solutions
Deciding when to outsource medical coding is different for every provider and it can be difficult to determine if it’s the right step. Here are a few considerations to keep in mind when deciding if it’s time to outsource medical coding.
Turnaround Time – Look at the overall turnaround time for your medical and billing process. If it's sluggish, resulting in delays or rework, then it may be time to look toward medical coding solutions.
Overworked Team – If your medical coding and billing team is overwhelmed with administrative responsibilities, outsourcing to medical coding service can greatly help reduce the workload, improving the speed while also giving your team room to breathe.
Accuracy – As mentioned before, accurate medical coding is imperative in the revenue cycle processes. If you're noticing less-than-ideal accuracy rates, this could be due to a lack of proper training, or resources that are stretched too thin, Either way, outsourcing can help here.
Revenue Goals – Consider your revenue goals and if you're meeting them. Outsourcing to expert medical coders may help achieve your revenue goals.
Medical Coding Audits – Some medical coding solutions offer additional services including medical coding audits. If you believe your company could benefit from a medical coding auditor, then outsourcing to a medical coding company may be a good option.
These are just a few aspects that providers need to consider. There may be other reasons why finding a medical coding solution may be the right step.
The Pros and Cons of Outsourcing
Nothing in this world is perfect and it's always important to look at the benefits and potential downfalls of every possibility when trying to decide on a path forward. In terms of medical coding solutions, it's not always obvious to providers that it's time to outsource to a medical coding service provider. In this case, it's a good idea to take a look at the pros and cons of outsourcing your medical coding services.
The Benefits of Outsourcing
Scalability and Consistent Staffing
When outsourcing your medical coding, it is up to the third-party company to keep staffing levels consistent. This means providers don't need to worry about their in-house coders having days off, being short-staffed, or anything in between. The medical coding company will keep up with the provider’s needs, meeting SLAs consistently.
Outsourcing to a third-party company can remain flexible and scale to you. The solution can be customized to your needs and can scale based on the changing needs of the business. At the same time, providers no longer need to worry about any hiring challenges when it comes to medical coders.
Achieving Revenue Goals
By outsourcing to a medical coding service provider, you will improve medical coding and billing turnaround time, receive reimbursements in a timely manner, reduce rework, and improve the revenue cycle. This in turn will help you achieve your revenue goals.
With in-house teams, it can be difficult to monitor and confirm consistent quality. However, medical coding services excel at this and deliver consistent high-quality results. Many will have a quality assurance process in place so they continue to produce high-quality work.
Up-to-date Certification and Education.
Medical coders require consistent continuing education to keep up with the compliance changes throughout the healthcare industry. This can be difficult for providers to confirm and keep up with which is why outsourcing to a company may be a significant benefit. The company will ensure their medical coders are up to date on all certifications and education that is required.
Potential Downfalls of Outsourcing
Depending on the medical coding service you choose, you may have less control over your processes than you would like. This can be especially true when hiring out to a different state or even country. Some providers prefer to monitor their medical coding and billing in-house. However, not all medical coding solutions offer in-house services.
Difficulty with Communication
Communication is key when it comes to collaborating with any third party. Medical coding is no different. If you choose to hire a medical coding company that is located in a different state or different country, you may be experiencing some communication difficulties due to different time zones and sometimes language barriers.
If you choose to go with a medical coding service provider, you may then need to consider the individuals who were currently working in your coding and billing departments. If the medical coding service is taking over all medical coding tasks, these other workers may need to be reassigned and retrained for other tasks.
Finding the Right Medical Coding Service
We understand that choosing to outsource your medical coding process is a big decision and that's why we at Exela want to make things simpler for you. Lexicode, an Exela company, has been providing medical coding services for over 40 years and can create customized medical coding solutions tailored to your company's needs.
Our team of seasoned HIM and medical coding specialists helps your company maintain efficient coding practices while reducing administrative costs. Our solution scales to each organization's needs and adapts quickly while maintaining productivity and quality in times of heightened demand.
We provide open communication with the support team, being available to providers when they need us, and keeping everything transparent. With our quality assurance and productivity monitoring, we maintain consistent, fast, and accurate results.
To see real results that LexiCode delivered, read our case study about how LexiCode provided a medical coding solution to help a regional healthcare provider facing staffing challenges.
Whether you're looking to add on services to supplement your current team or you're looking to completely outsource all coding needs, LexiCode can help. Learn more about LexiCode and its impressive medical coding solutions today.