The pandemic “changed everything”—and “everything” should include how you answer, “should we outsource medical coding services”?

If you haven’t considered your relationship with medical coding companies since before or even early on in the pandemic, now is an excellent time to take advantage of the opportunity. And yes, it is an opportunity. Right now, smart healthcare providers around the country are looking at the disruption in the world as a chance to discover new efficiencies, increase their competitive advantage, and prepare themselves for a future of revenue cycle challenges no one has seen before.

Benefits of Medical Coding Companies in the Age of COVID

Of course there have always been multiple benefits of outsourcing medical coding services, but let’s review how they’ve changed since the COVID-19 pandemic.

Adjusting to the “Next Normal”

The period you’re operating in right now has been called “one of the worst economic crises of modern times” [1]. While that might sound severe, it also means that we’re headed into a period where “normal” looks different than it did a few years back.

Your staff is already strained by the demands of telehealth program implementations and changing patient preferences. Consider the fact that, as recently as March 2020, polling revealed that 65.6% of Americans said that they doubted the quality of care they would get through telehealth appointments. By March 2021, that had shifted dramatically, with 87.82% saying they wanted to continue using telehealth services after the pandemic subsides [2].

These changes are going to be especially difficult to navigate as the Department of Health and Human Services (HHS) continues to update billing standards. You will need to keep up with shifting Medicare payment policies, changing fee-for-service opportunities under telehealth, falling reimbursements for uninsured patients, and changes in commercial plan reimbursement just to start.

“Normal” is going to be a period where organizations like yours will need to ride waves of change like this one, meaning ineffective revenue cycle management can mean the difference between success and failure. Determining what’s effective will mean considering all of your options, including the chance to outsource medical coding services in areas where your current staff might not be the strongest.

Freeing up Resources

One of the key benefits of outsourcing medical coding services is that it frees up your resources to focus on higher-value tasks. While this has always been true, this benefit is even more pronounced today.

It’s impossible to truly understand what the future holds for an organization like yours, meaning committing to finding, training, and retaining a large staff might not be a good decision right now. Instead, you’ll see benefits from taking action that frees up existing resources to adjust to a changing future.

Reducing Errors in a Difficult Denial Environment

Did you know that the vast majority of your denials are likely preventable? An analysis of hospital claim denials between July 2019 and June 2020 found that 86% were avoidable. At the same time, claim denials have been found to be steadily increasing, and at a faster rate since the COVID-19 pandemic hit [3]. What does all this mean? It means that you likely have a significant opportunity to improve denial management by tapping into knowledge outside your organization.

Improving Cash Flows

Rethinking your approach to medical coding services can pay off in big ways with cash flows. Healthcare providers like you face highly specific challenges, ranging from new CMS updates, to changing commercial reimbursement, increasing denials, and patients taking on a growing portion of financial responsibilities. Now is a great time to look at your use of virtual care and changes in your overall strategy, and align your approach to outsourced medical coding services to ensure healthy cash flows for the future.

Best Practices in Rethinking Your Relationship to Medical Coding Companies

When refreshing your strategy in working with medical coding companies, go in with a plan. Here are a few best practices that will help you get the most of your new approach to medical coding services.

Redefine Your Processes

Good outsourcing starts with a solid understanding of your current processes. If you haven’t taken the opportunity to examine and redefine your processes for the “COVID era”, this is a great place to start. Document all the steps that your coders take, along with how decisions are made (by supervisors, coders, or analysts). This will be extremely helpful in finding the medical coding service that best aligns with your needs and in getting the most out of the relationship.

Build Your Team

What works for processes also goes for your people. Now is the time to paint a picture of the type of team you’ll need in a world shaped by COVID-19. This will include billers and coders who are trained on pandemic-related changes, along with talent who understands the technological implications of your new telehealth and telemedicine strategies.

Keep in mind that you don’t have to outline exactly where you want to outsource medical coding services at this point. You can discuss that with your potential partners, who will also be able to offer advice and insight once you have a general idea of what your personnel needs are.

Rethink Your Training

COVID-19 has changed your training needs. Before the pandemic, your biggest looming training challenge was likely ICD-11 (and that was years down the road). Changes in telehealth and COVID-related billing have emerged and are challenging organizations like yours with new skill demands on your billers and coders.

Before looking at medical coding companies, take time to assess where your biggest training needs are and how you plan on addressing them in the future. Whoever you choose to partner with for medical coding services will be able to use that as a starting point to determine where they can save you time and money in filling in skill gaps.

Look for Expertise

You want expertise in your coders and the same goes for any medical coding company that you work with. This is especially true for your organization type and focus. Whether you’re a hospital, long-term care provider, or surgical facility – in all these cases you’ll want both individuals and partners that understand your unique situation and who can provide you with answers to emerging challenges.

Considerations When You Outsource Medical Coding

Most importantly, keep in mind that this is a journey and the right partner can act as a guide. Prioritize your future today and you’ll see benefits in terms of increased efficiency and organizational resilience. If you want help in implementing anything discussed in this article, feel free to contact us.

 

References
[1] J. LaPointe, “Best Practices When Outsourcing Revenue Cycle Management,” RevCycleIntelligence, 23 October 2020. Available: https://revcycleintelligence.com/features/best-practices-when-outsourcing-revenue-cycle-management.
[2] K. Adams, “How American attitudes on telehealth have changed since the start of the pandemic,” Becker’s Hospital Review, 7 April 2021. Available: https://www.beckershospitalreview.com/telehealth/how-american-attitudes-on-telehealth-have-changed-since-the-start-of-the-pandemic.html.
[3] J. LaPointe, “Hospital Claim Denials Steadily Rising, Increasing 23% in 2020,” RevCycleIntelligence, 4 February 2021. Available: https://revcycleintelligence.com/news/hospital-claim-denials-steadily-rising-increasing-23-in-2020.

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