5 Traits of Top Medical Coding Companies

Are you aware of the potential of the growing offshore medical billing industry in recent years? According to the current industrial report published by Mordor Intelligence, the growth forecast in the market size of the outsourced medical billing and coding industry is expected to be at a CAGR of 10.5% from 2020 to 2025. North America holds the largest market of end-users of the healthcare industry like hospitals, standalone clinics, and laboratories. With the growing complexities of the healthcare billing requirements, the provider organizations must adjust themselves and their finance with the help of experienced offshore medical coding partners.

Related: Simplifying Medical Coding for Beginners!

On the other hand, it is also true that the number of medical billing and coding companies is increasing exponentially, and it often becomes confusing to choose the right partner for your business. Research also shows that the monopoly of a few companies leads to a rise in outsourcing costs and thus skews the financial picture of healthcare organizations. In such a situation, if you are looking for a suitable outsourcing partner among top medical coding companies, you must know the essential qualities to look for in them.

This article has highlighted five such traits that you must search for in top medical coding companies.

1. Training and Experience:

  • The true purpose of outsourcing medical billing and coding to offshore companies is to ensure that every step of the coding and billing cycle is error-free and updated.
  • The billing teams of top medical coding companies have competent professionals with years of experience in this field.
  • Moreover, they also undergo regular training programs to stay updated on the latest changes in medical coding and billing guidelines by federal agencies like the CMS and TJC.
  • The first trait that you should look for in a prospective partner is if the billers and coders in the company are well trained during induction and attend regular staff training programs on the job.
  • Some top medical coding companies hire only professionals with the standard certification from the American Academy of Professional Coders (AAPC). You can shortlist candidates according to these requirements.

2. Attention to Detail:

  • Medical coding requires a keen eye for detail since every layer of complexity in the diagnosis and treatment needs to be monitored through the codes.
  • Missing a single code out or improper assignment of codes to the different medical procedures affects the reimbursement value of the claims.
  • Coders in the billing teams of top medical coding companies ensure that they do not miss out on any codes and modifiers so that the provider gets the most out of it.
  • In addition to the regular medical procedures, medical coders have been struggling with the evolving Covid-19 codes since the beginning of 2020. Professional updated coders stay on top of the latest changes put forth by the federal agencies.
  • Some of the top medical coding companies have dedicated teams for different medical specializations. Communicate with their team and know if they have experience in the specialization you need.

3. Exceptional Analytical Skills:

  • Experts from the medical billing and coding industry often admit that the entire picture of the revenue cycle management works like a giant puzzle piece. The billers and coders have to take a try now and then to fit everything together finally.
  • This is the reason why the top medical coding companies ensure that their assigned teams have exceptional analytical skills and problem-solving capacity.
  • A good grasp of the analytical skills in this niche industry comes from a thorough knowledge of the medical terminology and proven models of medical billing.
  • An outsourced billing and coding team also acts as the chief communication point between the different players in the medical billing ecosystem, like the payers, the patients, and the providers.
  • Billing teams from top medical coding companies ensure that they follow up regularly with the payer networks with the required documentation for the smooth operation of the revenue cycle.

4. Advanced Technology:

  • Working with a bulk of medical bills can lead to significant errors in the claim process, delaying the reimbursement or complicating it further.
  • The top medical coding companies try to avoid the complex hassle of dealing with erroneous claims in the first place by eliminating manual entries as far as possible.
  • Most companies come up with their own home-grown solution to automate the entire process of checking the codes and filling up forms so that any error due to manual processing can be eliminated.
  • In other cases, these companies invest dearly into advanced technology to work towards a frictionless revenue cycle. Make sure they also have sufficient security features to monitor the navigation of patient data.
  • On the other hand, the healthcare organization can save up on investments in new technology and maintenance of the same, thus improving the bottom line of the company.

5. Compliance Measures:

  • Top medical coding companies make sure that they are compliant with the federal and other state policies to continue serving the healthcare organizations better.
  • HIPAA is one of the most crucial standards that companies abide by to ensure the protection of the sensitive health information of patients.
  • Apart from the basics, the leading medical billing and coding companies offer secure delivery centers offshore. It is advisable to communicate with their measures when discussing the prospects.
  • Top medical coding companies also keep track of the latest resources issued by the Office of Inspector General (OIG) from the Department of Health and Human Services (HHS) and try to implement voluntary measures.
  • Auditing and monitoring a regular compliance program helps the medical coding and billing companies to identify and eliminate any red flags that might cause harm to the operations. ¬†

Staff Training Programs for In-house Team

  • Medical coding companies have expert professionals with decades of experience under their wing to cater to the different needs of the healthcare organizations.
  • The veterans, with years of hands-on experience in the coding industry, keep a proper tab on the different evolutions of the coding rules followed in the industry.
  • Knowing the coding updates like deleted codes, edited codes, and new codes are not enough if you want to truly ramp up your revenue cycle management.
  • The coders in your in-house team need to understand the application of the codes and how they can use them correctly to get the necessary reimbursement without getting downcoded by the payer.
  • Staff training modules from top medical coding companies will help your staff navigate through the various complexities of the claim preparation process.
  • The expert advice from the experienced professionals will add a separate dimension to the regular workflow management, thus improving the efficiency of the system with increased revenue flow.
  • Get in touch with a leading RCM company to know how they can help you and your in-house billing team fare better. ¬†

This article highlighted the five most common yet crucial traits of top medical coding companies in the world. If you think we missed out on any important point, please let us know in the comment section below, and we will get back to you. Please subscribe to our blog for more such pieces on the medical billing industry, technology, and financial management. Follow us on LinkedIn, Twitter, Instagram, and Facebook for more.

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