Learn how our Managed Operations model provides the perfect middle ground between outsourcing and incorporating.

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November 2018 | Outsourcing Blog | BPO Industry Updates and Articles

Outsourcing your medical coding is a practical and cost-effective way to delegate a time-consuming and intricate process so you get to invest more of your time and money to provide quality healthcare services.

When finding the right medical coding vendor, you should look for the one that offers the right services and resources that you are looking for, along with competitive rates and scalable packages.

Compliance Standards

Ensure that you are looking for an outsourcing partner that employs a team of AHIMA- or AAPC-certified medical coders who are trained on ICD-10. Compliance with relevant quality assurance and security standards and regulations should also always be considered.

Scope of Service

It's better to outsource all your requirements to a one-stop shop. Claims processing consists of different stages, with each stage requiring specific skills and experience.

  • Initial claims entry
  • Claims status updates
  • Payment posting
  • Claims denial management
  • Collections

Look for a vendor that can provide you end-to-end revenue cycle management services.

Integration

Different vendors operate with different types of software programs. Compare the processes of each potential outsourcing partner and find out which one can easily be adapted to your operations. Most outsourcing firms allow you to specify the software and systems that you need and they will set up the resources. For transparency and accessibility, choose a service provider that uses online portals and cloud-based systems.

Pricing

In addition to comparing service rates and pricing models, also find out if there are additional fees or if they offer add-ons. Are there installation costs or startup fees? If ever you decide to increase your practice’s size, will the rates be affected? Will there be additional costs for software upgrades?

Also, remember that cheaper isn't always better. Make sure to prioritize the quality of service and the scope of services that you need to meet your needs.

Reporting

Make sure that you can access information and reports in real time, and that online databases and dashboards are easy to navigate. In addition to online access, ask the vendor the frequency of their reports and what will be included. You want to find a provider that will send you reports consistently, at least once a month. The reports that you want to be included are denial, operations, and data analysis reports.

Reviews and Referrals

Aside from looking for credentials and certifications, you must also consider what other customers think of the services and reliability of the medical coding provider. Look for providers that have clients that have the same nature of business as yours, with the same size and have outsourced the same medical coding processes that you require. It’s also best to ask other healthcare practices for their recommendation.

Contract Requirements

Medical coding and billing are crucial processes, so you must ensure you understand what the contract guarantees and that all the important details are indicated. Make sure you know what the minimum contract requirement is and that there is a clause noting how you can opt out if the provider is not meeting your expectations.

Support

When you outsource your medical coding to a provider, find out what kind of support you will be receiving. Who will be your contact person? Will there be an account manager? What is the level of control you will have? Outsourcing providers will not only help you recruit and set up an offshore office space, they also provide support services such as HR management, IT support, facilities management, and finance.

When it comes to control, firms that have the traditional outsourcing model hold all operational control. But for businesses that still want to retain control over their offshore operations and take advantage of the benefits of outsourcing, there's also the managed operations model. This approach involves a local dedicated management team that will help you oversee your operations, but the KPIs, the processes, and the standards will be up to you.

Conclusion

Ultimately, don't rush your decision. The vendor selection process and negotiations can take time, but it will all be worth it once you find the outsourcing vendor you were looking for. For everything to go smoothly, ensure that all involved are in the loop and have clear communications.


Even if you're well-versed in handling your own payroll for your company, many businesses are still choosing to outsource their payroll to save on costs and improve productivity. Think of it this way – payroll is a time-consuming process, and the time and effort you take in doing a non-core process could have been spent on figuring out how to improve your business and increase your revenue.

Just like any other services, there are things to consider in making sure you outsource your payroll to the service provider that’s right for your business. The guide below may serve as your checklist when choosing a payroll outsourcing partner.

Know What You Need

Before searching for options, you must know first what kinds of payroll services you need. So when you talk to outsourcing providers, you will be able to tell them what you are looking for. Identifying what you need will also help you find out the questions you need to ask and the answers you need to look for. Some services that payroll outsourcing providers offer include continuous payroll processing, adjustment management, tax filing, and analysis reports, among others.

Get Recommendations

While searching for payroll providers that offer the services you need, getting recommendations can help you narrow down the choices. Ask your friends or colleagues who work in the same field, look at reviews and testimonials, and hear what other companies with the same nature as yours have to say about their experiences, especially with accuracy and responsiveness.

Check the Provider's Credentials

Now that you've listed down the payroll services you need and narrowed down your candidates, the next step is to find out if the services fit your requirements and if the processes and systems are flexible. Payroll processing is time-sensitive, so basically, look for a provider that releases the paychecks on time, pays your payroll taxes on time, and files your payroll tax forms on time. You should also look for a provider that is accredited and complies with international standards. In addition to your list of services that you require, find out if add-ons are being offered and the costs that come with them.

Ask the Right Questions

As part of understanding the payroll provider and its services, prepare the questions you need to ask. Some providers have forms that you have to fill out with your project specifications. This helps the provider to know more about your business and work they can offer you. On your end, remember to ask specific questions like:

  • What are the pricing options?
  • Which payroll taxes are included in the service offered?
  • What kinds of data and insights will be included in reports and dashboards?
  • How often will the reports be sent?
  • Is the payroll system customizable?
  • Is the data stored in the cloud and can be accessed on any device?
  • Is the system easy to use?
  • What are the security systems in place?
  • Are the services scalable?
  • Can the services be integrated with existing systems?
  • What kind of customer support is being offered?
  • What are the support services available (HR services, facilities, etc.)?
  • How fast is the turnaround?
  • Who will handle the account?
  • Who will be the point of contact for questions and concerns?
  • Is there employee self-service access?

Get a Quote

Once you've chosen one or two potential payroll providers, get a price quote that breaks down all the fees for the services you require. Get a quote for your first year and for your second year to see if rates change over time. This will help you compare the options and see which package will stay within your budget.

Prepare to Outsource

Before or upon signing the contract, you also need to know what you need to provide so the outsourcing will transition smoothly. Prepare organized files that include necessary employee details and other assets or data the payroll outsourcing provider will need.

In summary, the key to choosing the right payroll service provider is to know what you need, know and understand the services available, and aim for the best match. Due diligence can be arduous and time-consuming, but it’s the best way to ensure that you get the best available service at the best possible costs.