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:
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.
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.
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.
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? 2. How does outsourcing healthcare coding solve staffing issues for practices? 3. How does outsourced coding help in streamlining workflows for healthcare practices? 4. Why is outsourced coding considered a solution for small practices? 5. Is outsourcing healthcare coding more expensive than hiring in-house coders? 6. What can practices expect from MedCycle Solutions’ comprehensive outsourced coding services? 7. How can my practice get started with MedCycle Solutions’ expert outsourced coding services? |