Should Your Organization Use a Medical Billing and Coding Company?

Consider All of These Important Pros and Cons Before You Decide

Trying to decide whether your organization should use a medical billing and coding company can feel like an unfunny version of the party game “Fortunately/Unfortunately.”

For every “pro” you can think of about outsourcing these important but specialized and time-consuming tasks, you can also think of a “con.”

Should the “fortunate” or “unfortunate” factors carry more weight?

At MDCodePro, we think this decision is one of the most important a healthcare organization can make. It creates both immediate and long-term consequences for your records, your staff, and your revenue.

So we want to share what we see as some “fortunate” and “unfortunate” facts about using medical billing and coding outsourcing companies.


What Outsourced Coding Services Could Mean for Your Organization

Already worth $10.6 billion in 2016, expert analysts anticipate the global medical coding market will show a 10% compound annual growth rate through 2025.

Will your organization help drive that growth by signing a medical coding services contract with an outside company?

Consider these “fortunate, unfortunate” pairs:

  • Fortunately, medical billing and coding companies will lower your staff expenses.
    When coders aren’t your staffers, you don’t pay their salaries. It takes a robust salary to get qualified, experienced coders on staff. They’re in demand—the Bureau of Labor Statistics forecasts 13% growth for the field through 2026—and certified coders earn $51,477 on average, the AAPC reports. Not only will you avoid having to pay salaries like that, you won’t have to provide benefits, vacation and sick days, or office space. 
  • Unfortunately, medical billing and coding companies don’t have staff members’ advantages.
    Because your coders work remotely, you can’t manage them directly. You’ll have no say in how they’re trained, and you won’t know how turnover affects the team unless you ask. Your coders may not work in the same time zone as you do, making it harder to resolve questions about documentation efficiently, which could slow down how quickly you get paid.
  • Fortunately, medical billing and coding companies can increase your revenue.
    Because these companies focus exclusively on getting your charts coded and submitting your superbills for payment, you may see your revenue cycle accelerate. And these companies may be able to appeal denied claims faster and at higher levels than your organization could. More money may head your way sooner than if you handled all your own coding and billing (though don’t forget: medical coding company fees grow as your income does). 
  • Unfortunately, medical billing and coding companies can’t see extra revenue opportunities.
    Off-premise coders can’t watch patient visits take place, as in-house coders occasionally can (and should). They can’t point out something billable the doctor is doing but isn’t documenting. In-house coders can help providers start properly noting these actions in order to claim reimbursement for them, as coding and compliance strategist Barbara Hays told Physicians Practice.
  • Fortunately, medical billing and coding companies tend to have the latest coding knowledge.
    Remote coders’ exclusive focus on their task means they have more time than you and your office staff do to study and stay on top of constantly changing diagnostic and procedural codes. As a result, their coding should be extremely accurate, which will mean fewer denials and faster reimbursement for your organization.
  • Unfortunately, medical billing and coding companies won’t help you learn more about coding.
    Even if you outsource your medical coding, you don’t outsource your responsibility for complying with CMS documentation guidelines. In-house coders help physicians learn more about coding in the routine course of their work together, and documentation compliance grows as a result. Vendors of outsourced coding may save your organization time and money, but they can’t add the educational value coders on the premises can.


Grow Providers’ Medical Coding Knowledge with MDCodePro

Depending on your organization’s size and scope, outsourcing some or all of your medical billing and coding to other companies may make sense. But whether you use staff or outside coders, you can equip your physicians with a stronger knowledge of how and why to code patient visits optimally with the MDCodePro app.

The app is really an online medical billing and coding course helping busy physicians rapidly master the basics of the CMS guidelines, then rely on those basics every day to produce more accurate and compliant documentation supporting the highest appropriate CPT® code.

Efficient and effective, and validated in multiple audits, the MDCodePro method has allowed doctors who’ve learned it to increase their annual revenue by $30,000 on average.

Move toward less reliance on outside medical billing and coding companies and more revenue for your organization’s bottom line. Sign up for your MDCodePro subscription today.

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