5 Reasons Why Rural Hospitals Should Consider a New Coding Approach

1. The ongoing shortage of experienced coders is hitting your organization.

Knowledgeable, experienced coders have long been in demand – but between the implementation of ICD-10 and the COVID-19 pandemic, the situation has become more complex than ever. Coding has become exceptionally complex – especially in places like CAHs, whose coders must cross-train to work across multiple specialty areas without interruption. And with fewer people than ever enrolling in coder education and certification programs, the shortage shows no signs of subsiding.

Especially in today’s environment of coder scarcity, smart coding service providers employ recruiters dedicated specifically to coding professionals. They will operate at a scale that enables them to pay their coders a high hourly wage without forcing unusually high charges onto their clients. They’ll have programs in place to retain existing staff. And they’ll maintain a pipeline of talent for future needs, as well.

2. Your coders face ever-increasing quality and productivity demands.

As healthcare technology evolves, so does coding complexity – especially in high-risk and specialty areas. Likewise, when healthcare systems acquire physician practices, they often find themselves with new professional fee coding responsibilities that their coders may not have the experience to manage. Then, there’s the question of assuring productivity and quality. When coders fall below expected quality and productivity levels, organizations find themselves with an impossible choice: Keep the coder but risk speed, accuracy, and even compliance issues. Or, terminate the coder and face the consequences of working short-staffed.

An excellent coding partner will have a proven approach for vetting prospective coders. Equally important, they’ll provide continual professional development and testing to keep their coders sharp. That training and education will both reinforce existing processes and bring their coders up to speed with the latest demands of multiple types of healthcare organizations. They’ll conduct quarterly reviews and have specific action plans for consistently maintaining high standards.

Accurate, defensible, compliant coding is essential to the revenue cycle of all healthcare organizations. That level of coding demands experienced, knowledgeable, high-integrity coders. Yet, many organizations – especially Critical Access Hospitals (CAHs) – struggle with this crucial capability.

Outsourced coding isn’t the right solution for every organization. So, how do you know if it’s right for yours? Consider the following five essential reasons to pursue an outsourced solution:

3. Your coding load rises and falls – and it’s costing you money.

Healthcare organizations often struggle with the expense of excess staffing during periods of low demand – whether because they employ extraneous coders during times of low demand or because they spend money on temporary coders in times of high demand. Those temporary coder costs go well beyond their hourly rates, too -- including what it takes to bring their institutional knowledge up to speed, integrate them into the organization, and ensure quality control.

There is significant value in a coding partner who takes the time to learn the ebbs and flows of your coding load and your overall corporate culture. That knowledge enables them to scale up and down with your coding requirement, providing virtually instantaneous coverage when you need it – and keeping you from having to pay for coders when demand is low. They’ll also take the time to understand how your organization and department operate and prepare their coding professionals to fit in seamlessly.

4. You’re located in a rural or underserved urban zone.

Many healthcare organizations require staff to live within their geographic area – even if those staff members are permitted to work remotely. As a result, issues ranging from infrastructure and education quality to safety make it difficult to attract and retain qualified coding talent.

In an outsourced coding partnership, the coders are the partner’s employees, so they may not be bound by your organization’s residency requirements. However, your agreement with them can ensure full coding support, on-site and off-site, wherever you may be.

5. The expenses and stresses of an internal coding department are a burden.

Increasing costs and decreasing reimbursements are challenging virtually every healthcare system. However, when you add in the costs of recruiting, hiring, onboarding, training, continuing education, and retention of an internal coding department, the financial burden can become overwhelming.

When you outsource your coding to the right partner, you don’t spend time, money, and resources on building and maintaining an internal team of coders, ensuring quality, productivity, compliance, and even the software coders must use. The partner takes responsibility for those elements, which reduces your burden significantly.

Many healthcare organizations are struggling with some or all of the challenges that may impede the consistent coding excellence necessary to achieve successful revenues. If yours is one of them, you owe it to your balance sheet to consider the advantages of the right outsourced coding partnership.