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4 Questions to Consider Before You Outsource Your Medical Encoding

by: Mary Christine Galang

Tuesday, July 25, 2017 |

Choosing to outsource your medical encoding can significantly help with the bulk of work that this job entails, which requires efficiency and being up-to-date with the industry regulations, among other things.

It is, without a doubt, a highly important job. A hiccup in the process can result in delays in billing, claims, and reimbursements. The financial and technical aspects can greatly affect the patients’ well-being in many ways we might not anticipate.

In addition, billing and coding software have become integral to various kinds of operations and fields of profession. Depending on your needs and preferences, outsourcing can readily provide use of the latest technologies available.

Although in many smaller practices, both medical billing and coding are handled by one employee; the nuances between the two might overlap drastically as the workload gets heavier and file organization harder to manage.

Outsourcing Your Medical Encoding

If you are ready to outsource your medical encoding, consider these four questions:

1. What should I look for in an offshore medical encoding provider?

As a growing industry, there are a lot of companies that offer medical encoding and/or billing. Finding one that will not only fit your needs but will also help draw and optimize revenue for you is important. Secure this information:

  • Do a research (or consult) on companies with an excellent compliance record, especially when it comes to industry regulations.
  • Reputation and length in the business
  • Learn about their past and present clients. Ask for reference.
  • Availability of professional liability insurance.
  • Ask for a written contract of their provided services and a written compliance plan.

2. What are the qualifications of their employees?

A professional medical coder must have an extensive knowledge of anatomy and medical terminology and thoroughly familiarized with the codebook resources CPT®, HCPCS Level II, and ICD-10-CM and their coding systems. They must obtain the Certified Professional Coder credential.

The company must conduct regular seminars, training, and ongoing education to ensure their professional coders are up-to-date with the latest practices, as well as the new CPT and HCPCS codes.

3. How much does outsourcing medical coding services cost?

One of the driving factors of seeking third-party services in any field is to cut on costs. Medical coding outsourcing companies supply you the software needed, like Encoder Pro, TruCode, and FLASH CODE.

You will save on training fees and traditional employee benefits as well. The coding company ensures that their staff is highly trained and efficient as they take on jobs.

It is essential to find out about the company's start-up fee. You might be outsourcing the operation, but ultimately, you will still be responsible for refunds and claims.

4. Is the company compliant with regulations?

In the U.S. in particular, an HIPAA-compliant company is crucial in choosing your medical coding and billing company. This ensures that patients' rights are protected, especially when it comes to medical information. Coding (and billing as well) is not just a form of data entry. Safeguarding patient confidentiality is the cornerstone of this profession.

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