Comprehensive Outsourced Healthcare Coding & Auditing Services

 

Navigating the complexities of healthcare changes, including the shift to ICD-10, has made finding outsourced healthcare coding experts more challenging than ever. Accurate coding is crucial for smooth operations, while errors can result in delayed payments, rejections, and audits.

Benefits of Our Outsourced Healthcare Coding & Auditing Services:

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Solve Staffing Issues with Outsourced Healthcare Coding

Many of our client practices are experiencing short-term staffing issues like turnover or leaves of absence. In these cases, the practice needs to be filled immediately, and backfilling or hiring new staff takes too long. MedCycle Solutions employs a team of Certified Professional Coders with the experience your team needs to fill the gaps.  

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Outsourced Coding: A Solution for Small Practices

Small or start-up practices often don’t have the financial resources to hire a full-time certified medical coder on their staff. Our clients use us as their coding team. We become an integral part of their business, becoming familiar with their specialty and the coding intricacies of their specific practice.

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Streamline Workflows with Efficient Outsourced Coding

Outsourcing part or all of the practice’s coding functions can be an effective way to streamline workflows.  Outsourcing your healthcare coding ensures that your workforce is efficient and effective and minimizes wasted time. Our clients are assigned dedicated coding staff that learns their practice and works efficiently to ensure accurate and timely medical coding. 

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Debunking the Cost Myth of This Service

A common myth about outsourced healthcare coding services is that it is more expensive than employing in-house resources. When benefits, PTO, meeting time and lost productivity due to turnover are factored in, outsourced coding is almost always comparable to employing in-house coders.

Our Auditing Process

Step 1: Initial Consultation & Assessment

Our process begins with a phone consultation to understand your needs, objectives, and any specific concerns related to coding and compliance. Whether you need an annual compliance review, a focused audit on a specific issue, or an external resource for internal compliance efforts, our auditing services are tailored to meet your needs.

Step 3: Quality Control & Compliance Verification

Our audit team strives to meet compliance standards in following the Official Guidelines for Coding and Reporting developed by the American Medical Association (AMA), American Hospital Association (AHA), Centers for Disease Control (CDC), National Center for Health Statistics (NCHS), the Centers for Medicare and Medicaid Services (CMS) and published by the American Hospitals Association’s Central Office on ICD-10-CM quarterly newsletters, formally known as ‘Coding Clinic’, as well as CPT Assistant published by the American Medical Association.

Our team works collaboratively to ensure audit findings are consistently applied. We follow a multi-tiered quality control process to verify the accuracy of coding, billing, and documentation compliance.

Step 5: Post-Audit Consultation & Education

Upon completion of the audit, our clients receive:

  • An informative discussion reviewing the audit findings and key areas for improvement and how to properly address them
  • An educational plan for providers, coders, and/or billing staff to support future coding and billing accuracy while supporting compliance standards.

Step 2: Comprehensive Chart Review

Certified and experienced auditors will conduct a detailed review of selected medical records to ensure at a minimum:

  • Evaluation and management levels are supported per documentation for medical decision making or time-based coding.
  • CPT/HCPCS/Modifier code accuracy and proper reporting
  • ICD-10-CM coding accuracy and specificity to ensure correct diagnosis coding
  • Charge capture validation, ensuring all billable services are documented and reported.
  • Edit review for unbundling

Step 4: Audit Findings & Recommendations

Each audit includes a detailed written report outlining the following:

  • Identified coding inaccuracies with information enriched rationales
  • Documentation enhanced opportunities, when identified
  • Areas of potential compliance risk along with corrective actions
  • Recommended process and documentation quality

If requested, we can also provide a financial impact analysis showing how coding variances affected revenue based on audit results.

FAQs

1. Why should my practice consider outsourcing healthcare coding?
Outsourcing healthcare coding can address short-term staffing issues, streamline workflows, and provide a solution for small practices that may not have the financial resources to hire a full-time certified medical coder. MedCycle Solutions offers a team of Certified Professional Coders to fill immediate gaps efficiently.

2. How does outsourcing healthcare coding solve staffing issues for practices?
Many practices face short-term staffing issues like turnover or leaves of absence. MedCycle Solutions provides a solution by employing a team of Certified Professional Coders, ensuring immediate coverage and minimizing the delays associated with backfilling or hiring new staff.

3. How does outsourced coding help in streamlining workflows for healthcare practices?
Outsourcing part or all of the coding functions can streamline workflows by ensuring efficiency and effectiveness in the coding process. MedCycle Solutions assigns dedicated coding staff to clients, learning their practice intricacies and working efficiently to ensure accurate and timely medical coding.

4. Why is outsourced coding considered a solution for small practices?
Small or start-up practices may lack the financial resources to hire a full-time certified medical coder. MedCycle Solutions serves as the coding team for such practices, becoming an integral part of their business, familiar with their specialty, and handling coding intricacies efficiently.

5. Is outsourcing healthcare coding more expensive than hiring in-house coders?
Contrary to a common myth, outsourced healthcare coding services are often comparable in cost to employing in-house coders when considering factors like benefits, PTO, meeting time, and lost productivity due to turnover. MedCycle Solutions debunk the cost myth associated with this service.

6. What can practices expect from MedCycle Solutions’ comprehensive outsourced coding services?
Practices can expect consistency, accuracy, timeliness, and professionalism when outsourcing part or all of their coding function to MedCycle Solutions. The dedicated coding staff ensures high-quality coding services tailored to the specific needs of each practice.

7. How can my practice get started with MedCycle Solutions’ expert outsourced coding services?
Initiating a partnership with MedCycle Solutions is simple. Contact us to discuss your practice’s specific needs and explore how our Certified Professional Coders can efficiently support your coding requirements, providing consistency and accuracy to enhance your practice.

Boost Your Practice With Our Expert Outsourced Coding and Auditing Services