Outsourcing and offshoring are two significant factors that help you boost the revenue cycle process. They help bring in certified coders who could institute lesser denials, enhance reimbursements and eliminate revenue leakages. Therefore, it can be crucial for healthcare and revenue cycle managers to choose the right service provider when it comes to outsourcing. In addition, it helps you boost the coding quality.

You can help uncover potentiality for healthcare institutions through state-of-the-art technology tools, increased revenue, and an accelerated cash flow cycle.

Outsourcing and offshoring the medical coding process

Certified & expert coders

The process of reviewing and coding a medical record requires trained personnel who are well versed with the different coding systems, including but not limited to the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedural Coding System.

Medical coders are expected to have a good amount of knowledge regarding medical terminology, anatomy, and clinical terminology. In addition, they need to interpret and assign codes based on provider documentation.

Here, medical coders should know and understand different insurance guidelines and apply those when coding the records. The hospital revenue cycle management includes skilled specialists, well-trained and, on top of that, professionally certified when handling clients.

Meanwhile, offshore coders play a significant role in medical revenue cycle management. The experts undergo robust training and complete a certification program to ensure rich skills that can bring in the required knowledge and experience.

With access to well-equipped talent, providers' practices can now enhance their revenue sky-high as the accuracy of the coding system improves.

Patient care

Healthcare firms must focus on comprehensive patient care, diagnosis, documentation, and conducting necessary tests and procedures. Therefore, when clinicians go through the RCM process for billing and coding accuracy, they prioritize the proper delivery of patient care.

With absolute participation in medical revenue cycle management, the entire revenue cycle can now be efficiently handled. Moreover, experts here not only improve the quality of coding but also billing for enhanced reimbursements.

When it comes to an outsourced platform, healthcare firms can now look into different ways to enhance patient care and experience.

PHI and HIPAA Compliance

When you outsource medical revenue cycle management, you no longer need to worry about how patient information gets handled, abiding by PHI and HIPAA compliance; as the RCM service provider makes significant investments in information security management solutions, it's essential to provide clients with a secure operating environment and rigorous sets of control. It's more about ensuring data security and client satisfaction.

Quality assurance

Running healthcare audits is a typically robust process. Moreover, it brings increased first-pass resolution through engagements of RCM processing. Also, hospital revenue cycle management also aids in the discovery of missing or unbilled procedures, thus increasing revenue sources.

Running a robust audit and clinical documentation framework helps you recover more money and ensure nothing gets left out on the table. Medical coding is one process that requires a strong quality assurance program. You must ensure coding accuracy is on par with industry standards.

Enhanced compliance

To keep your coding and billing compliances intact, it can be necessary to improve the quality of coding and billing processes. All standard procedures and guidelines must be thoroughly documented and followed, even for payer-specific requirements.

Certified coders already come under the framework. The offshore service provider is well versed with the medical necessity guidelines, compliant use of modifiers and local coverage determinations (LCDs), and up-coding and down-coding errors; this helps your firm avoid better coding quality.

Seamless cash-flow

Outsourcing enables coders with indisputable expertise over coding standards. This ultimately helps improve the accuracy. The more precise the coding gets, the sooner would be the claims processing. Improving billing and coding aspects of healthcare services will help enhance the first pass resolution rate, improving the revenue cycle.

Economical practices

Outsourcing and offshoring provide healthcare practices with an economical solution, including reduced workforce requirements, first-pass resolution rates, and faster turnaround time for claims submission; there are added advantages when you have access to state-of-the-art technology.

You must also know that the unavailability of certified coders can be a significant challenge. Moreover, hospital revenue cycle management has found out how industries face spiraling losses due to reduced reimbursements and increased timelines for claims resolutions.

When you outsource the medical revenue cycle management, healthcare firms can now lift the burden off their shoulders. This helps increase their time and money. You must always go for the right service provider that offers a robust framework, helping effectively manage day-to-day operations.

Things to look for in an offshore company 

• Focus on certification

In medical coding, there's more about converting billable diagnosis and procedure into acceptable codes. However, error or mishandling in medical coding also impacts the other scopes of medical billing, time wastage, and effort.

Missing to code any billable diagnosis procedures indirectly means lost revenue. Here, medical coding is crucial in determining the claims reimbursement and cash flow to the business. Coders must be certified by the American Association of Professional Coders (AAPC) and Ameican Health Information Management Association (AHIMA).

Certified coders are now required to maintain their certifications by continuing education units every two years. This indirectly means the demand for experienced and certified coders is exorbitant.

• Better ROI

With offshore-based hospital revenue cycle management, key areas impact your ROI and work proactively to enhance regular cash flow. It's more about ensuring a better return of investment; as most billing companies charge for their services on the percentage of collections tied to accuracy and quality, it is apparent that they aim at delivering substantial ROI, assuring you with more significant savings.

• Enhanced scalability

Outsourcing the medical coding helps you scale up on the cash inflow, mainly when you handle coding volume, even during the high-demanding season. In addition, hospital revenue cycle management eliminates you from the stress of absenteeism and attrition. This helps you provide continuous support even during challenging times such as COVID-19.

• Flexible pricing and contracts

Most offshore billing partners are flexible regarding contracting options, pricing, and timings. Offshore medical billing firms offer a different range of pricing models, including models like percentage of collections. They also analyze the current coding and billing setup and suggest the best pricing model that suits the business.

Final Wrap

Vital Solutions is one of the pioneering medical billing companies based in the U.S. We're a team that promises to avoid the risks involved with missed charges. With years of experience in the industry, we have been providing medical coding and end-to-end medical claims processing services.

You must expect efficient offshore medical billing, medical coding, and accounts receivables services by leveraging the right resources and solutions. This helps resources and solutions enhance practice performance and thereby increase reimbursements.   

Medical billing and coding are far too important to be left to chance, particularly in an era when financial and resourcing pressures weigh heavily on health executives. Instead, you need to look for offshore qualified; experienced staff is the smart way to ensure you give the organizations the best chance of running a system that delivers for clinicians, patients, and the bottom line.