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White Paper
Optimize Your Medical Coding Accuracy and Efficiency
Summary
Partner with a single, expert vendor to obtain the greatest ROI
Whitepaper | LaTonya O’Neal
Vice President, Revenue Integrity and Centralized Coding, Change Healthcare
LaTonya leads coding, compliance audit, charge capture, and clinical documentation improvement services for hospitals, health systems, and physician practices.
If you outsource your medical coding, or are considering it, you’re in good company. Hospitals, health systems, and physician practices seeking to gain efficiencies, reduce costs, and improve revenue—often find that centralizing coding with an expert vendor is a wise decision.
Outsourcing Options
Coding complexity has evolved to the point where it makes sense to rely on staff who can stay abreast of continuous regulatory and health plan changes, and who know the right code combinations to optimize revenue. Plus, economies of scale are gained when staff and functions are centralized and there’s robust, continuing education in denial trends and code nuance, as well as specialty certifications.
Sometimes providers will work with multiple vendors when they outsource medical coding, often because they think competition reaps better pricing or because they doubt a single vendor can offer expertise in all specialties. But one of the primary reasons for outsourcing coding is to gain efficiencies—and working with multiple vendors is not efficient.
Additionally, I’ve found the greatest gains in coding improvement and financial performance are realized when one vendor functions as an extension of the provider’s staff, working hand-in-hand with the revenue-cycle team to share knowledge and strengthen the entire billing process for the practice, hospital, or health system.
Five Key Advantages of Working with a Single, Expert Vendor
Through our work with thousands of practices and hospitals, Change Healthcare has identified five essential advantages of engaging a single-source, medical-coding vendor:
1. Timely, Accurate Enterprise-Wide Reimbursement
Coding success requires the ability to conduct regular trend analyses and respond in ways that will optimize revenue. It demands consistent, rigorous compliance standards to facilitate timely, accurate reimbursement while protecting against costly audits and penalties. And, the greatest gains are made when these results are delivered across the entire enterprise, not just to individual locations, departments, or practices.
2. Greater Efficiency
Working with multiple coding vendors is inefficient. At the corporate level, multiple vendors can drive expenses high with numerous purchasing arrangements, legal agreements, and contracts. At the director level, there are more relationships to manage. In contrast, a single vendor with multi-specialty expertise simplifies management, can reduce coding expenditures, and drives overall efficiency.
3. Better Data and Insights
When working with multiple vendors, you’re likely to encounter different technologies, which can lead to incompatible reports and content that cannot be aggregated to identify patterns and trends. Even with a consistent set of metrics, each system typically generates a unique report, requiring custom, time-consuming programming to deliver useful information.
4. Clear Communications
Optimizing your processes will involve continuously incorporating improvements. Success is dependent on clear, consistent communication to physicians and coding specialists. Working with one vendor helps ensure that occurs, whereas working with multiple vendors can result in conflicting direction and input. Likewise, when you have questions or concerns to be addressed, it’s more efficient to have the conversation with one vendor vs. numerous.
5. Better Trend Recognition and Response
A single-source medical coding vendor can quickly see trends across different specialties, population groupings, payers, and even among individual physicians; by contrast, multiple vendors can only identify trends within their own silos. The latter makes it difficult for you know when a minor problem identified in one department is actually a major issue system-wide. Also, when an improvement needs to be implemented, it’s easier to scale system-wide with one vendor vs. working individually with multiple vendors.
Choose Well
When you decide to select one outsourcing vendor to optimize your medical coding, do your homework before choosing. You’ll want to see broad and deep experience—across specialties and with many clients. Assess the vendor’s knowledge of staying abreast of industry updates and ask how staff are trained and evaluated to ensure continuous quality improvement. You should also request examples of the vendor’s success in helping customers improve revenue via increased coding accuracy and completeness.
Learn how our Revenue Integrity and Coding Services can help you optimize revenue, control costs, and improve compliance by calling 844-798-3017 or visit: https://www.changehealthcare.com/solutions/coding-compliance-advocate
