Medical Coding Solutions Guide

Not up to date on the latest coding changes? Then you’re probably losing revenue.

Most providers struggle to keep up with complex payer rules. Are you managing staff who do coding, but don’t have a good sense of how well they’re actually performing?

Good news—You don’t need to be an expert in coding, while also caring for patients.

Lots of providers have figured out that outsourcing medical coding makes sense.

Imagine not dealing with irritating letters and zero-pay EOBs from insurance companies!

Many savvy providers no longer waste their valuable time fighting denials and down-coding.

They don’t have to stay on top of the latest payer tricks…or worry about bundling and unbundling procedures…

Because they’ve found a cost-effective alternative:  coding experts who take care of everything for you.

How It Works

To outsource, you hire a third party vendor to do your medical coding. instead of doing it in-house. Depending on the company you choose, certified medical coders may work on your claims remotely, or on site at your office. Once the provider finishes a visit or procedure, a coder accesses the medical record. The coder reads the notes and any other pertinent information in the patient’s chart and completes the coding.


Advantages of outsourcing coding include:

  • Increased revenue. Optimized coding equals better reimbursement.
  • Decreased expenses. Cut your labor and benefits costs, and reduce office space needs.
  • Reduce risk. Minimize the risk of improper coding and audits.
  • Improve cash flow. Fewer claim rejections means faster payment. Also, no more delays when staff are on vacation or sick.
  • Better capitation payments. For providers in risk contracts, expert coding improves risk scoring, leading to better reimbursement.
  • Gain access to broader labor markets, with specialty-specific, top talent.
  • Outsourced coders don’t have competing job duties.
  • Focus on patients. Providers can see patients instead of doing their own coding or supervising coding staff.
  • Keep coding costs in line with volume changes and seasonality.
  • Let coding experts supervise coders.

Keys to Successful Outsourcing

Things to consider:

  • What kind of ratings does the company have? Can they provide references from practices in your specialty?
  • Responsiveness. How well does the company communicate?
  • Qualifications. Do all coders have AAPC, AHIMA, or other certifications?
  • How long has the company been in business?
  • Technical capabilities. Will they work in your EMR/PM system?
  • How big is the team of coders?
  • Data Security. Obtain written guarantees of HIPAA and other compliance.
  • Cost structure. What scope of services is included? Are costs volume-driven? Are there any hidden add-on fees?
  • What types of performance reporting will they provide? Will they help you improve your documentation?
  • Service Level Guarantees. Do they offer any service level guarantees in terms of timeliness or accuracy?
  • Contract terms. Check termination and other clauses.

Want to learn more and get rate quotes? Fill out the form above to connect with qualified medical coding companies.