Case Study: Advanced Coding Solutions for Medical Billing Company

Overview

Medical Coding CompanyOutsource Strategies International (OSI) is a comprehensive medical billing, coding and outsourcing company. We offer medical coding for different specialties including psychiatry, chiropractic, internal medicine and cardiology.

We were approached by an Alabama-based medical billing company, Advanced Physician Solutions, which provides medical billing services for various specialties. Their clients are located in Alabama. They particularly excel in solutions dealing with AR Management, Technology and Practice Administration.

The Challenge

Though our client excelled in medical billing, collections, and revenue cycle management they did not have the required expertise in coding to help their clients obtain maximum reimbursement. They wanted OSI to be their silent partner to review their clients’ medical records and provide the required coding.

The Solution

OSI got to work by implementing a team of AHIMA-certified coders who had vast experience in the required specialties. A project manager was assigned for the management of the production and process. The quality of coding is essential since only a correct code can help secure maximum reimbursement. So we had weekly meetings for reviewing the quality of the coding and also ensuring that all expectations and protocols are met. In short, our coding solutions were high quality, confidential and cost effective.

The client first wanted a trial. So they sent us 10 scanned charts uploaded on our FTP. We followed the coding requirements specific to the locality of the provider and provided all linked ICD-9 and associated modifiers required for proper billing. The coded files were returned via spreadsheet.

The Result

On returning the work, the client was not only impressed with our accurate coding, but also benefited from some issues we identified that could directly impact the provider’s revenue.

We discovered that the providers were under-coding in many cases which not only decreased reimbursement but could also lead to the payers initiating an audit. We could offer guidance when there was a lack of medical documentation in the chart, and also crosswalk codes depending on the billed insurances. Our AHIMA-certified coders are experts in federal as well as commercial coding and billing guidelines.

The client is extremely pleased with the medical coding services we are offering and our competitive prices too. Outsourcing the coding has had a very positive impact not only on their business but also on that of the clients they serve.