Deloitte Survey Indicates Now Is a Great Time to Outsource Medical Coding Image
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Deloitte Survey Indicates Now Is a Great Time to Outsource Medical Coding

As the challenges in the U.S. healthcare landscape continue to become more complex, healthcare revenue cycle leaders across hospitals, health systems, and physician groups will benefit from looking at new ways to outsource medical coding. From the long-term impacts of new federal legislation, to workforce shortages and the rise of AI-enabled payers, U.S. healthcare providers can no longer look at medical coding outsourcing as an option – it’s a strategic necessity. 

Instead, it should be leveraged as an opportunity to tap into skills, resources, and services that aren’t available internally. This perspective will be critical as competition for specialized skills increases and the tech arms race progresses. Outsourcing medical coding services should be a foundational pillar for building the kind of multidimensional sourcing ecosystem that this survey from Deloitte addresses [1].

To help you and your team better understand the role that medical coding outsourcing can play at your organization, we’ve put together the highlights from the survey for your review.  By prioritizing the benefits and strategies addressed below, you can transform your medical coding operations from a cost center into a strategic asset. 

Maturing Your Approach to Medical Coding Outsourcing

For U.S. hospitals, health systems, and physician groups, outsourced medical coding services are becoming a cornerstone of revenue cycle strategy. Delivery models are becoming more sophisticated and beginning to emphasize relationships based on value over simple cost savings. 

While some respondents to the survey reported beefing up internal operations, investments in external partnerships were also featured heavily, with only a few respondents planning a decrease. Back-office functions continue to be outsourced at higher rates, but organizations are increasingly focused on creating greater value from core competencies. For revenue cycle leaders considering medical coding outsourcing, this trend is worth paying attention to. It highlights the fact that a strategic approach to medical coding outsourcing can be a decisive factor in achieving operational agility and securing skilled talent, and more than just a cost cutting measure.

The Deloitte survey highlights this shift away from a focus on cost savings in outsourcing.  This evolving perspective redefines the value proposition of outsourced services – moving the focus from sourcing inexpensive labor to acquiring high-value capabilities, like specialization in the healthcare revenue cycle. 

Revenue cycle leaders should now prioritize improved access to talent, enhanced service quality, and greater agility, in addition to spend optimization. While cost reduction will remain a consideration in medical coding outsourcing, the strategic priority must be on discovering continuous opportunities for creating incremental value. This means working with your revenue cycle vendor to access talent, integrate advanced technology, and enhance core capabilities.

Access the Distinct Value of Back-Office Outsourcing

The survey reveals that back-office outsourcing remains a foundational component for many organizations. These functions are being outsourced at elevated rates, allowing businesses to concentrate on their primary competencies while benefiting from a provider’s specialized knowledge to continue driving operational efficiency. By focusing on back-office outsourcing, U.S. healthcare revenue cycle departments can access benefits including:

  • Enhanced access to medical coding talent
  • Improved quality and performance
  • Ability to gain access to new capabilities

Medical coding services, a critical back-office function, are prime candidates for this model. Revenue cycle departments should adopt a comprehensive sourcing strategy and integrate outsourced medical coding services as an integral component of their overall operating model. This approach moves beyond a piecemeal solution, positioning the department to capture the full benefits of a strategic partnership.

Prioritizing Value-Based Relationships and Addressing Challenges in Your Revenue Cycle Outsourcing Strategy

To maximize the impact of your investment in a medical coding outsourcing partner, focus on vendors who are experienced in healthcare and who can provide a relationship based on value. 

Deloitte recommends collaborating with your service provider to explore new areas of creating this value. 

Keep in mind, many organizations encounter challenges in their outsourcing programs, many of which stem from internal management capabilities. The survey points out key internal obstacles to success, including: 

  • An inadequate approach to organizational change management
  • Poor integration of vendor services
  • An inability to track and report on realized benefits
  • Insufficient financial oversight

To get ahead of these challenges, revenue cycle leaders need to bolster their internal management capabilities and apply them directly to outsourced services. This includes areas of competency including: 

  • Value management
  • Performance oversight
  • Effective vendor relations

To maximize value from an outsourcing program, your leadership should reach out to embrace strategic measures in their outsourcing program. This includes defining a comprehensive sourcing strategy and integrating outsourcing as a fundamental part of your global operating model. In the world of outsourcing medical coding, this translates into a need for a well-defined strategy that considers the impact on the entire revenue cycle function.

Future-Readiness Hinges on Talent Sourcing

To prepare for the future, revenue cycle departments must leverage external partnerships to manage complexity and deliver results. The possibilities of the modern talent pool are expanding, and organizations are adjusting their sourcing approach to gain flexibility, efficiency, and access to specialized skills.

No executive from the Deloitte survey reported relying exclusively on internal employees for their talent requirements. For a provider considering a medical coding outsourcing partner, this means looking for a vendor with a sophisticated approach to talent management, beyond simple staff augmentation. Providers should look for opportunities to collaborate across internal departments, developing new competencies, and potentially recruiting personnel with a broad experience of managing diverse talent models. A well-executed medical coding outsourcing program can be a key part of this overall talent strategy.

Supercharge Your Medical Coding Outsourcing Strategy With AI

The Deloitte survey highlights the importance of a fresh strategic perspective on your outsourcing practices. This type of strategic partnership can help your organization access a deeper pool of skilled medical coders, enabling improved accuracy and reduced claim denials.

These benefits are greatly enhanced when working with a partner that leverages AI solutions on top of their deep experience in healthcare. At 3Gen Consulting, our AI coding platform, CodeGen-i, combines the speed and efficiency of AI-assisted coding with the assurance of certified coder review. Every chart is validated by an experienced coding professional, so clients gain both productivity and a higher level of accuracy. To learn more about how we can partner as a part of your future-ready outsourcing strategy, contact us today.

 

References

[1] Deloitte, “Global Outsourcing Survey 2024,” 5 February 2025. Available: https://www.deloitte.com/content/dam/assets-zone3/us/en/docs/services/consulting/2024/us-global-outsourcing-survey-2024-report.pdf.

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RADV Audits & Risk Adjustment Coding in 2025: How Medicare Advantage Plans Can Protect Revenue

RADV audits just got real. In 2025, Medicare Advantage (MA) plans are facing the true financial impact of inaccurate or incomplete risk adjustment coding.

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A recent HFMA study shows that hospital CFOs see revenue cycle – especially medical billing accounts receivable and denials management – as the biggest area of opportunity for AI [1]. This raises a key question: what do revenue cycle leaders need to do to prepare? Considering the complexity of AI technology, choosing a good partner with “pre-AI” revenue cycle expertise is

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7 Best Practices for Medical Billing & Coding Services That Boost Revenue and Reduce Denials Image
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7 Best Practices for Medical Billing & Coding Services in 2025 to Boost Revenue and Reduce Denials

If you’re a U.S. healthcare provider searching for medical billing and coding services, you’re not alone. Thousands of physician practices, hospitals, and labs nationwide are rethinking how they manage revenue cycle operations – because missed modifiers, lost claims, and endless denials are draining revenue.

Medical billing and coding errors cost U.S. providers billions annually — not just in unpaid claims, but also in compliance risk, staff burnout, and unhappy patients. The good news? With the right blend of technology, process, and expertise, most of these issues are preventable.

Here are 7 proven best practices that top-performing practices, physician groups, and hospitals use to keep cash flow healthy, denials low, and compliance airtight.

1. Keep Your Medical Coding Guidelines Updated — Always

Billing and coding are constantly evolving. Every year, CMS, AMA, and commercial payers release updates to CPT, ICD-10, and HCPCS codes. Missing even one update can lead to underpayment or denials — especially in specialties with frequent coding changes like radiology, pathology, and behavioral health.

Best Practice:

  • Maintain a living medical coding manual updated quarterly.
  • Subscribe to payer alerts and CMS updates.
  • Use AI-powered medical coding tools to flag outdated codes before claims go out.

Pro Tip: U.S. practices that review coding guidelines regularly see 15-20% fewer denials related to coding errors.

2. Verify Patient Eligibility Upfront

One of the most common reasons for denials? Ineligible patients. Nothing is more frustrating than delivering care and discovering after the fact that coverage lapsed or prior authorization was required.

Best Practice:

  • Run real-time eligibility checks for every patient.
  • Verify coverage for high-cost procedures and check prior authorization requirements.
  • Document payer reps’ names and reference numbers when you confirm coverage.

Industry Insight: According to MGMA, eligibility issues account for nearly 27% of claim denials [1]. Catching them upfront saves you rework and write-offs.

3. Get Documentation Right the First Time

Clean documentation is the backbone of clean claims. If the diagnosis doesn’t support the CPT, or if signatures and dates are missing, your claim will end up in a denial queue.

Best Practice:

  • Use a documentation checklist that includes DOS, provider signature, and diagnosis-procedure match.
  • Standardize templates in your EHR for consistency.
  • Perform spot-checks on high-value procedures before submission.

Even a single missed modifier (like 25, 59, or 26/TC) can mean a $500+ revenue loss. Getting it right upfront pays off – literally.

4. Track Key Medical Billing KPIs Like a Hawk

You can’t improve what you don’t measure. Practices that monitor their revenue cycle KPIs consistently outperform those that don’t – and can intervene early when something goes wrong.

Best Practice: Track at least these core metrics:

  • Clean Claim Rate (Target: 95%+)
  • First Pass Resolution Rate
  • Days in AR (Target: < 35 days for most specialties)
  • Denial Rate by Category

Use a medical billing dashboard to visualize trends and take action before denials snowball into revenue leakage.

5. Perform Regular Coding Audits

Medical coding audits aren’t just for compliance – they’re for revenue protection. Undercoding costs you money, while overcoding can trigger audits and penalties.

Best Practice:

  • Conduct quarterly internal audits (retrospective + pre-bill).
  • Train your staff on findings so errors don’t repeat.
  • Use audits to identify missed units, unbilled add-on codes, and downcoded encounters.

Our experience shows that proactive audits can recover 3-7% of missed revenue without increasing patient volume.

6. Automate Medical Billing & Coding Workflows

Manual data entry, claim status chasing, and payment posting are productivity killers. The best U.S. practices are investing in automation and AI-driven RCM platforms to streamline processes.

Best Practice:

  • Leverage AI-assisted coding tools to reduce errors.
  • Automate claim status checks, payment posting, and denial routing.
  • Integrate your EHR, clearinghouse, and billing platform to eliminate duplicate data entry.

Providers using automation report 20–30% faster reimbursement cycles and lower staff workload.

7. Train & Upskill Your Team Continuously

The medical billing and coding landscape changes fast – and a one-time training isn’t enough.

Best Practice:

  • Host quarterly lunch-and-learns on payer changes.
  • Encourage coders to maintain AAPC or AHIMA certifications.
  • Provide feedback loops: share audit findings and celebrate improvements.

The Bottom Line: Best Practices Pay for Themselves

Implementing these best practices doesn’t just clean up your healthcare revenue cycle, it also improves compliance, reduces staff burnout, and keeps patients happier. 

But keeping up with payer changes, coding updates, and endless claim follow-ups can overwhelm even the best in-house teams.

That’s where RevGen-i, 3Gen’s AI-powered revenue cycle management platform, comes in. With RevGen-i, U.S. healthcare providers get:

  • Real-time eligibility verification to stop denials before they start
  • Intelligent analytics dashboards to track clean claim rates, denial categories, AR days
  • Workflow automation for claim status checks, payment posting, and follow-ups
  • Seamless integration with EHR and billing systems for a frictionless workflow

Together with our expert billing team, RevGen-i helps U.S. providers stay compliant, capture every dollar, and get paid faster, without adding staff or complexity.

Ready to see the difference? Schedule your free RCM assessment and see how much revenue you might be leaving on the table.

References

[1] MGMA, “6 keys to addressing denials in your medical practice’s revenue cycle,” 18 March 2021. Available: https://www.mgma.com/mgma-stats/6-keys-to-addressing-denials-in-your-medical-practice-s-revenue-cycle.

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