New Innovations in Medical Coding Make Outsourcing Necessary

For years, vendor partners were icing on the cake for many healthcare providers – medical coding outsourcing services were something leadership considered under specific circumstances or in response to certain external pressures in the industry. This, though, has changed. Innovation and disruption in the industry now mean that the days of maintaining an effective revenue cycle strategy without third-party support have faded into history. But medical coding outsourcing is an increasingly valuable solution. 

When providers outsource coding and coding audits to reputable vendor partners, they access deep experience from partners with insights into several different specialties as well as coding for their specialty for other clients. The result is volume efficiency. This creates an advantage through working with a coding team that has an improved and broad perspective on coding accuracy, thus reducing denials or under-payments related to coding and improving cash flows.

Medical coding outsourcing has now become a foundational requirement for the healthcare revenue cycle – and this is because of a few specific innovations, outlined by the American Health Information Management Association (AHIMA) [1].

Telehealth and Remote Coding

Coding is now a decentralized process, which means providers don’t have to limit themselves to coders in their local region. This means more flexibility in hiring, but if you’re taking advantage of remote coding and moving the process off premise, you should also consider outsourcing. 

Interoperability

Payers, providers, and other stakeholders expect advanced interoperability. While some providers are equipped to provide this level of performance, many should consider tapping into outsourcing to access improved interoperability without the hassle of internal transformation. 

Risk Adjustment Coding

The shift toward value-based reimbursement means that providers will face increased pressure to accurately capture patient conditions. Calculating the risk of a patient population is incredibly complex, and as this complexity increases, most providers will need the support of medical coding outsourcing. 

Patient-Centered Health Records

While this innovation reaches well beyond the world of rev cycle, it can have a significant drain on organizational resources. Patient centered initiatives require in-depth knowledge and up-close contact with patients. Most organizations will need to dedicate more resources to achieve any measurable level of success. For most, this is an opportunity to move revenue cycle resources on to higher-value tasks and leverage medical coding outsourcing services to free up personnel and key talent. 

Making smart use of outsourcing in the coming future of healthcare requires a shift in perspective. Instead of asking where you can use medical coding outsourcing services, leadership should flip the premise – instead asking, “Where and how will we use medical coding outsourcing services and where can we find the best alignment with our organizational goals and obstacles?” This can be a challenging question to answer and should involve a few conversations with trusted vendors as early as possible in your planning process.