As the healthcare industry continues to grow, so too does the demand for quality medical coding. Medical coding plays a crucial role in the healthcare industry, facilitating accurate and efficient billing, reimbursement, and documentation processes. According to Grandview Research, the US medical coding market was valued at $17.9 billion in 2021 and is expected to have a compound annual growth rate of 8% from 2022 to 2030. However, the complexity and ever-changing nature of medical coding can pose significant challenges for healthcare organizations. In this blog, we will explore the challenges as well as the solution options you should consider. 

 

Challenges You May Face:

Revenue Goals – Meeting your revenue goals means you need to maintain fast turnaround times.   You may need help to improve or supplement coding processes or you may need to evaluate and improve processes that causes delays or rework.

Staffing – Quality coders are in high demand and many providers find it challenging to hire staff.  When your team is understaffed and overwhelmed, errors and delays in coding are inevitable.

Accuracy –Inaccurate coding can result in under or overbilling, trigger audits, or cause denials, all of which impact revenue and disrupt cash flow.  There are also possible legal and financial repercussions, reputation damage, and compromises in data integrity for research, health management and policy making.

Before selecting a medical coding solution, it's important to understand these challenges, then align your goals, budget and resources. Also consider factors such as the volume of coding required, the complexity of your coding and abstracting requirements, and the level of expertise available within your organization. 

 

 

Solutions You Can Explore:

Outsourcing: Many healthcare organizations chose to outsource their medical coding needs to specialized coding companies. These companies employ trained coders and use a combination of manual coding and technology-driven tools to ensure accurate and timely coding. Outsourcing coding services can be cost-effective and relieve healthcare organizations of the administrative burden associated with coding. However, it requires careful selection of a reputable coding partner and clear communication to maintain quality and compliance.

Staff Training: Another approach is to invest in training your existing staff members in medical coding. This can be done through workshops, online courses, or hiring certified coding instructors. By developing an in-house coding team, you can have more control over the coding process and address coding-related issues more effectively.

Consulting Services: If you need assistance in optimizing your coding processes or ensuring compliance, you can consider hiring consulting firms that specialize in medical coding. These experts can review your coding practices, identify areas for improvement, and provide guidance on coding guidelines and regulations.

Technology: There are numerous software solutions available in the market specifically designed for medical coding. These tools often include features such as automated code suggestions, coding validations, and integration with electronic health record (EHR) systems. Investing in such software can streamline the coding process and improve efficiency.

 

 

Finding the Right Medical Coding Service 

At LexiCode, we understand that choosing the right medical coding solution is a big decision. Let us create customized medical coding solutions tailored to your facility’s needs. We have been providing medical coding services nationwide for over 40 years. Our team of seasoned HIM and medical coding specialists in 4 countries can helps your company maintain efficient coding practices while reducing administrative costs. 

Our Outsourced Coding Solutions scale to each organization's needs and adapt quickly in times of heightened demand or in the face of unexpected regional disasters, while maintaining productivity and quality coding services.   We provide open communication with the support team, are available to clients when needed, and keep everything transparent. With our quality assurance and productivity monitoring, we maintain consistent, fast, and accurate results. To see real results that LexiCode delivered, read our case study about how LexiCode helped a regional healthcare provider facing staffing challenges.

LexiCode’s robust Virtual Training Platform provides world-class coder training in all specialty areas.  Independent study or instructor-led options are available and can be customized to meet your specific needs. We can also deliver provider education that focuses on documentation best practices.

To assure that your facility is coding accurately, LexiCode Consulting Services can perform in-depth analysis and modeling to determine risks and accuracy in coding and help your team implement corrective actions.  Our team of seasoned professionals can provide an extensive portfolio of consulting services, from medical necessity reviews to coding and compliance audits.  

Through our world-class coding technology partners, we can offer several Software Solutions to meet your needs.  We work together to bring services and software solutions to our clients.

Remember, accurate and compliant medical coding is crucial for reimbursement, data analysis, and overall operational efficiency. Therefore, it's essential to invest in reliable coding solutions that align with your organization's goals and requirements. 

 

Learn more about LexiCode and our impressive medical coding solutions today.

 

As the healthcare industry continues to grow, so too does the demand for medical coding. According to Grandview Research, the US medical coding market was valued at $17.9 billion in 2021 and is expected to have a compound annual growth rate of 8% from 2022 to 2030. Due to medical coding being a complex task coupled with its exponential growth, many organizations consider using medical coding solutions. Accurate coding is vital for healthcare providers to receive timely reimbursements and process claims efficiently. 

Medical coding solutions include outsourcing to a medical coding service, an external company that helps with coding tasks. These solutions are often varied and customizable, depending on the medical coding service picked. The provider may work with a company that takes all the medical coding to an external location. Another scenario is that the provider may use the company to supplement their own in-house team. Finally, the provider may select a company that works in-house with their team. There are many options when it comes to outsourcing and looking for a medical coding solution.

 

When to Look for Medical Coding Solutions 

Deciding when to outsource medical coding is different for every provider and it can be difficult to determine if it’s the right step. Here are a few considerations to keep in mind when deciding if it’s time to outsource medical coding. 

Turnaround Time – Look at the overall turnaround time for your medical and billing process. If it's sluggish, resulting in delays or rework, then it may be time to look toward medical coding solutions.

Overworked Team – If your medical coding and billing team is overwhelmed with administrative responsibilities, outsourcing to medical coding service can greatly help reduce the workload, improving the speed while also giving your team room to breathe.

Accuracy – As mentioned before, accurate medical coding is imperative in the revenue cycle processes. If you're noticing less-than-ideal accuracy rates, this could be due to a lack of proper training, or resources that are stretched too thin, Either way, outsourcing can help here.

Revenue Goals – Consider your revenue goals and if you're meeting them. Outsourcing to expert medical coders may help achieve your revenue goals.

Medical Coding Audits – Some medical coding solutions offer additional services including medical coding audits. If you believe your company could benefit from a medical coding auditor, then outsourcing to a medical coding company may be a good option.

These are just a few aspects that providers need to consider. There may be other reasons why finding a medical coding solution may be the right step. 

 

 

The Pros and Cons of Outsourcing 

Nothing in this world is perfect and it's always important to look at the benefits and potential downfalls of every possibility when trying to decide on a path forward. In terms of medical coding solutions, it's not always obvious to providers that it's time to outsource to a medical coding service provider. In this case, it's a good idea to take a look at the pros and cons of outsourcing your medical coding services.

 

The Benefits of Outsourcing

Scalability and Consistent Staffing 

When outsourcing your medical coding, it is up to the third-party company to keep staffing levels consistent. This means providers don't need to worry about their in-house coders having days off, being short-staffed, or anything in between. The medical coding company will keep up with the provider’s needs, meeting SLAs consistently.

Outsourcing to a third-party company can remain flexible and scale to you. The solution can be customized to your needs and can scale based on the changing needs of the business. At the same time, providers no longer need to worry about any hiring challenges when it comes to medical coders.

Achieving Revenue Goals 

By outsourcing to a medical coding service provider, you will improve medical coding and billing turnaround time, receive reimbursements in a timely manner, reduce rework, and improve the revenue cycle. This in turn will help you achieve your revenue goals.

Consistent Quality 

With in-house teams, it can be difficult to monitor and confirm consistent quality. However, medical coding services excel at this and deliver consistent high-quality results. Many will have a quality assurance process in place so they continue to produce high-quality work. 

Up-to-date Certification and Education. 

Medical coders require consistent continuing education to keep up with the compliance changes throughout the healthcare industry. This can be difficult for providers to confirm and keep up with which is why outsourcing to a company may be a significant benefit. The company will ensure their medical coders are up to date on all certifications and education that is required.

 

 

Potential Downfalls of Outsourcing

Less Oversight

Depending on the medical coding service you choose, you may have less control over your processes than you would like. This can be especially true when hiring out to a different state or even country. Some providers prefer to monitor their medical coding and billing in-house. However, not all medical coding solutions offer in-house services.

Difficulty with Communication 

Communication is key when it comes to collaborating with any third party. Medical coding is no different. If you choose to hire a medical coding company that is located in a different state or different country, you may be experiencing some communication difficulties due to different time zones and sometimes language barriers.

Reallocating Resources 

If you choose to go with a medical coding service provider, you may then need to consider the individuals who were currently working in your coding and billing departments. If the medical coding service is taking over all medical coding tasks, these other workers may need to be reassigned and retrained for other tasks.

 

 

Finding the Right Medical Coding Service 

We understand that choosing to outsource your medical coding process is a big decision and that's why we at Exela want to make things simpler for you. Lexicode, an Exela company, has been providing medical coding services for over 40 years and can create customized medical coding solutions tailored to your company's needs.

Our team of seasoned HIM and medical coding specialists helps your company maintain efficient coding practices while reducing administrative costs. Our solution scales to each organization's needs and adapts quickly while maintaining productivity and quality in times of heightened demand.

We provide open communication with the support team, being available to providers when they need us, and keeping everything transparent. With our quality assurance and productivity monitoring, we maintain consistent, fast, and accurate results.

To see real results that LexiCode delivered, read our case study about how LexiCode provided a medical coding solution to help a regional healthcare provider facing staffing challenges.

Whether you're looking to add on services to supplement your current team or you're looking to completely outsource all coding needs, LexiCode can help. Learn more about LexiCode and its impressive medical coding solutions today.

Healthcare organizations juggle many moving parts and two key processes that go hand in hand are medical coding and medical coding audits. Through medical coding audits, companies confirm that their practices are meeting regulatory and compliance expectations, and that they receive proper payment for the services rendered and resources utilized. Coding audits are reviews of healthcare organizations' coding practices, documentation quality, and billing accuracy. A comprehensive audit will validate that formal procedures are in place and being
adhered to, and will assess workflow efficiency. 

Medical coding audits act as a preventative measure so organizations can identify errors in billing and compliance quickly before they result in larger issues. Due to ever-changing guidelines and the ongoing need for coder education, coding audits serve an essential purpose in the healthcare practice. Organizations that do not regularly conduct coding audits risk financial loss when incorrect coding results in underpayments. Incorrect coding resulting in overpayments will result in a high rate of denials, and potential investigation and fines if the issues are repetitive and high volume.

 

Meeting Coding Compliance

How frequently a healthcare organization should audit its coding processes differs between companies. However, according to the HHS Office of the Inspector General (OIG), healthcare organizations are advised to perform a medical coding audit annually to confirm they are compliant. 

There may be reasons why organizations choose to perform audits more than once a year. An organization’s compliance plan may require more frequent audits. Depending on the root causes of previously identified coding errors, specific types of cases (targeted DRG, APC) may be appropriate. Audits may be built into performance reviews for coders or providers, requiring monthly or quarterly reviews. Every organization may have a multitude of reasons that support audits being conducted more than annually.

The OIG recommends a consistent accuracy rate of 95% or higher. If an organization is not meeting this recommendation, its leaders may want to assess if a monthly or quarterly audit should be put in place.

 

 

Benefits of Medical Coding Audits

Medical coding audits improve a company’s operations. By performing audits, organizations will see benefits including:

Maintaining Compliance: Compliance requirements consistently change as new regulatory guidelines are implemented. Medical coders need to stay current on all compliance guidelines. Through coding audits, companies can assure their medical coders are up to date with their continuous training. A coding auditor will identify any new regulations, payer rules, and laws that may affect coding practices. 

Avoiding Penalties: Healthcare organizations that are consistently cited for coding issues or irregularities may be flagged and find themselves under investigation. Not only are investigations time-consuming and costly, but they can also result in fines if the investigation identifies legitimate compliance issues.

Reducing Denials: Coding audits increase billing accuracy, which results in fewer claims denials. Claims are often rejected for minor errors and small inaccuracies that are very easily fixed. An average of 1 in 7 claims are denied due to mistakes that could easily be fixed prior to billing. Audits can very easily identify these high-frequency error trends and enable prompt corrective action that results in fewer claims denials and increased savings.

 

Retrospective and Concurrent Coding Audits

The timing of when audits are performed may differ based on the organization’s objectives. First, there's retrospective auditing which refers to the review of previously submitted claims. Concurrent audits refer to the review of claims before they are submitted for billing. While concurrent audits can help to increase immediate accuracy, it means that more time will be taken for claims to go to billing, impacting cash flow. Companies that are struggling with accuracy may find concurrent auditing useful because it tackles the issue right away. 

Retrospective audits help organizations see the larger picture and determine any ongoing procedural issues, errors, and trends. Both retrospective and concurrent audits have their benefits and pitfalls to consider. It might be useful to secure a third-party auditing company such as Lexicode to help determine which type of audit would be better based on an organization's needs.

 

Examining the Auditing Process 

The coding audit process is thorough and involves many different work steps. The first step will be to identify the type of audit that will take place, retrospective or concurrent. Auditors will then decide on a sample size, or how many medical records they plan to review; the sample may be random or targeted depending on the goal of the audit. This number will differ based on the audit type and the organization's size. For a smaller organization, 10 to 20 claims may be a good place to start and for larger organizations, 25 to 30 claims per coder/provider may be best.

Once the auditor reviews the sample with auditing goals and scope in mind, the detailed findings, including a root cause analysis, will be presented to the organization. Most importantly, the auditors’ recommendations will be valuable in identifying corrective action and how to best move forward. Alternatively, organizations may hire a consultant to help them determine how to best implement the recommendations for improvement.

Goals in coding audits include:

• Identifying gaps and inconsistencies in documentation
• Identifying irregularities in payer reimbursement
• Identifying incorrect application of medical codes and modifiers
• Identifying claims billed incorrectly according to payer rules
• Identifying any fraudulent practices

 

 

Internal vs. External Coding Audits

Organizations can choose to utilize an internal auditor or commission a company outside of the organization to conduct their medical coding audits. While it is up to the organization which type of auditor if preferred, all auditors need to be credentialed and experienced in medical coding and auditing practices. 

An internal auditor is most likely going to be an employee with other responsibilities since auditing only happens periodically. If the employee is feeling overworked and is unable to provide a thorough audit, this can present a problem when trying to establish a complete picture. At the same time, an internal auditor may be biased having worked in the coding department which could also result in inaccurate data.

Outsourcing coding audits to medical coding companies such as Lexicode can help organizations receive a more objective evaluation of their coding practices. With an outsourced company, the auditor will be fully engaged and dedicated to this particular task rather than juggling multiple responsibilities.

Lexicode provides organizations with coding audits and revenue impact assessments, denials management and appeals, HIM operational reviews, and a consulting team to support providers every step of the way. Lexicode also offers education services for medical coders and physicians so they can stay on top of their continuing education.

 

Conclusion

Medical coding is a key process in the healthcare industry and presents its own unique complexities and challenges. Through regular medical coding audits, providers can meet compliance standards, reduce denials, increase savings, and avoid investigations and fines. With LexiCode’s consulting and auditing services, organizations receive support and a thorough review to help them increase the accuracy of their claims and optimize their coding processes. With over 40 years of medical coding experience, LexiCode is a trusted brand in the healthcare industry. 

 

Revenue Cycle Management for healthcare organizations has never been more important. Put simply, this process involves optimizing revenue integrity by reviewing every administrative and clinical function contributing to the collection of revenue and applying best practices to ensure maximum reimbursement for healthcare services in a timely manner.

The healthcare revenue cycle is complicated and intricate, with many factors that impact who pays, how much they pay, and how they pay. Patients may have no health insurance and are billed directly. Others have Medicaid or Medicare. Many are covered through a private insurance plan, often offered through their employer, which could involve any of the numerous US insurance companies - and in some cases multiple companies in collaboration. Mix that with the wide range of visit types and procedures, as well as coverage terms like deductibles, copays, and coinsurance, and you’ve got an environment ripe for errors and missed opportunities.

Clearly, in today’s complex and fluid healthcare industry revenue cycle management is about much more than just billing and collecting payments. Fortunately, with the help of digital solutions and third-party administrators who specialize in healthcare billing, healthcare providers are able to manage the complexity of these billing cycles, maintain reliable cash flow and deliver high-quality care to their patients. 

 

The Goal of Revenue Integrity

According to the National Association of Healthcare Revenue Integrity (NAHRI), the goal of Revenue Integrity is “to prevent recurrence of issues that can cause revenue leakage and/or compliance risks through effective, efficient, replicable processes and internal controls across the continuum of patient care, supported by the appropriate documentation and the application of sound financial practices that are able to withstand audits at any point in time.” In other words, identify missed income for healthcare providers, determine the cause, and find ways to mitigate the issue in order to prevent it from happening with future payments.

Today, technology plays a crucial role in assisting providers, payers, and consumers in communicating efficiently, which breaks silos and improves durable revenue cycle management strategies. There are several critical areas that healthcare managers could focus on to ensure their medical facility optimizes its revenue cycle.
 

Reducing Claims Denials

As per the Healthcare Financial Management Association, claim denials cost an average of $5 million per year to each healthcare provider. Just reducing this amount could save a lot! 

More than 20% of healthcare claims are routinely denied, with some providers experiencing up to a 40% denial rate. However, 90% of these denied claims could have been prevented. 

Organizations can recover this loss by utilizing analytics that can provide a deeper view and help dig into patterns to understand the reasons behind denials. Such insights can help health systems implement prevention plans and procedures for recovering the denials.

A significant portion of revenue leakage comes from inaccuracies and errors that lead to denied claims. Unfortunately, the process of correcting and resubmitting these claims can also be costly and time-consuming. That’s why it’s critical for healthcare providers to take steps to prevent their claims from being denied. One proven strategy to reduce denied claims is partnering with a claims processing company like Exela. Our Global PCH solution substantially reduces the number of denials by correcting errors before the claims are even submitted, allowing healthcare companies to confidently submit “clean claims,” which are more likely to be accepted by insurance companies on the first pass.

By leveraging automation technology, streamlining communication between providers and payers, and reducing the number of resubmissions, PCH is able to significantly accelerate the revenue cycle time.

To learn more about Exela’s PCH solution, and for an in-depth look at Revenue Integrity, download this recent edition of Exela’s quarterly publication PluggedIN. 

 

Fix Medical Coding Errors 

Clinical documentation has a tangible impact on the revenue cycle. Unfortunately, there are cases where bills are unpaid due to documentation errors or medical coding. Managing these discharged-not-final-billed (DNFB) cases is essential for hospitals to improve revenue cycle performance.

Medical coding is a complex process requiring proper coding and proper documentation. Medical coders require compliance with government regulations and private payer policies as well as education in medical terminology, diseases, anatomy, and physiology. Documentation comes from the physician who needs to accurately detail the treatment and care provided so medical coders know which codes and modifiers to use. Any error could cost the provider. 

Due to its complex nature, healthcare providers may choose to outsource their medical coding needs. LexiCode, our medical coding services, aids providers of all sizes, scaling to each organization’s needs with quality assurance and productivity monitoring. Partnering with LexiCode, providers experience timely medical coding resulting in steady cash flow.

 

Hone in on Revenue Integrity

A revenue integrity (RI) plan is an essential component of optimizing the revenue cycle. This includes accessing current workflows for inefficiencies, implementing improvements, and upgrading technology where it can help. Unfortunately, not all providers have the time and resources to create a proper RI plan.  

Exela enables healthcare providers to attain revenue integrity through integrated solutions and proprietary technology that address the entire revenue and reimbursement lifecycle. Our Revenue Integrity solution helps identify and recover underpayments, maximize reimbursement from third-party payers, and provides a streamlined RI process. 

Leveraging decades of experience with Exela and our cutting-edge technologies, we maximize reimbursements and dollars recovered, and reduce or eliminate related overhead, all while enhancing employee, provider, payer and patient satisfaction. To know more in detail, take a look at our PluggedIN focusing on Revenue Integrity. 

 

As healthcare providers continue to focus on revenue integrity this year, ensuring accurate medical coding is crucial. With the help of accurate coding, providers achieve proper reimbursement. In short, an accurately coded medical record tells a payer what illness or injury is being treated, past medical history as well as treatment provided and procedures performed. 

Inaccurate medical coding leads to more denials, as well as over and underpayments thus preventing the providers from correct reimbursement. It's reported that one in seven claims are denied for various reasons but one of the most common reasons is medical coding errors. Also, medical coding requires compliance with government regulations as well as private payer policies. Inaccurate coding could cause significant challenges for a provider. 

As providers move forward with their 2022 initiatives, accurate medical coding needs to be a priority. One way to do this includes outsourcing to medical coding companies such as LexiCode. We’ll detail five keys to accurate medical coding and discuss how LexiCode delivers on each one of them.

 

1. Medical Coding Education

Medical coding requires a vast knowledge of not only medical terminology, but also disease processes, anatomy, and physiology. This knowledge is imperative for coders to ensure they are providing the correct codes for medical conditions, diagnoses, and procedures. Since medicines and treatments continually change, ongoing education and training are vital to being successful. 

With LexiCode, providers gain a dedicated team of credentialed medical coders that have access to many medical coding tools, references, and an education team. LexiCode provides the proper training and ongoing education of each coder allowing providers to focus on other aspects of the revenue cycle.

 

2. Staying Current on Medical Codes

Going hand in hand with education, providers need to be confident that the coders stay current on guideline changes since updates are published several times a year. Claims are often denied due to common issues including inaccurate code assignment, sequencing, or incorrect use of modifiers. Without assurance that coders are current in medical coding practices, providers are vulnerable to incorrect payments due to denial claims as well as potential compliance issues.

LexiCode participates in quarterly coding assessments and has a team of dedicated QA Analysts to ensure the coders are applying guidelines correctly.  By staying up to date and using the proper coding practices, LexiCode enables providers to obtain clean claims resulting in fewer denials and appeals. 

 

3. Proper Detailed Documentation

Documentation within the medical record becomes the source of communication between the provider and the coder. Without this documentation, coders lack the information to assign the appropriate codes reflective of the treatment and care provided. To enable accurate medical coding, providers need to make sure physicians provide detailed documentation with every patient. With the appropriate and correct documentation, medical coders can report the proper codes for accurate reimbursement. 

Another way to tackle this particular issue is to provide a way for physicians and coders to communicate with one another. Therefore, coders can reach out to physicians for any clarifying information needed to provide accurate coding.

LexiCode handles this seamlessly by beginning a physician query process when the medical record doesn't contain enough detail or needs further clarification. LexiCode follows any physician query process healthcare providers currently have in place. However, if a provider does not have a query process in place, LexiCode will follow its internal corporate compliance plan to obtain all the information required to enable accurate coding. Through physician queries, physicians help clarify items that are unclear in the record which leads to a more accurate reimbursement.

LexiCode also provides consulting services to include clinical documentation improvement (CDI) support and the development of education programs for physicians. LexiCode’s education program aids physicians by training them to provide the detailed documentation needed which results in fewer coding errors and queries while providing accurate revenue within a quicker time frame.

 

4. Consistent Staffing

The healthcare industry faced a multitude of challenges during the beginning and throughout the pandemic as emergency room visits increased and elective surgeries decreased. During times of crisis, healthcare providers often see drastic changes in their census which affects every aspect of the organization. 

Hospital volumes fluctuate on a normal basis sometimes providing coders with inconsistent work. Understaffing leads to coders rushing and possibly making mistakes, overstaffing leads to additional overhead costs and not enough work. LexiCode meets healthcare providers’ needs no matter the current census. As the census fluctuates in an organization, LexiCode scales with it ensuring that productivity remains consistent with agreed-upon quality metrics and compliance. 

 

5. Partnering with Medical Coding Companies

Partnering with a business process outsourcing (BPO) company comes with many benefits that providers should consider. With over 40 years of experience, LexiCode provides superior medical coding services to providers of all sizes. LexiCode scales to providers' needs with quality assurance and productivity monitoring. When they utilize LexiCode, providers can expect consistent staffing, high quality, and unparalleled staffing support.

LexiCode’s partnerships with hospitals, clinics, practices, or other healthcare providers allow for continuous cash flow with timely medical coding backed by our quality assurance and educational initiatives. 

 

The impacts of the COVID-19 pandemic reached nearly every industry in the economy, but none more directly than healthcare.

Even as the pandemic subsides in many parts of the United States, healthcare organizations will be facing new challenges. Many people postponed visits and elective procedures in order to maintain physical distancing guidelines and avoid potentially crowded medical facilities, and these appointments are already coming back up.

While frontline medical staff bore the brunt of the pandemic, support and administrative staff have also been stretched thin and faced increased pressure over the past two years. One behind-the-scenes process that plays a critical role in maintaining a functioning healthcare industry is Health Information Management (HIM).

Why is HIM so important?

To understand the importance of HIM, it helps to start by defining what’s meant by “health information.” Simply put, any data pertaining to an individual’s medical history - from reported symptoms, to diagnoses and procedures, to lab results and X-rays, to clinical information and physician’s notes. Anything that helps track the patient’s health over time from any interaction with a healthcare provider goes into their health record.

Accurate health records provide doctors with valuable context for a patient’s condition and leads to better diagnoses and better health outcomes for the patient. On a larger scale, extensive health records for entire populations offer a bird’s-eye view of larger health trends and can help inform policy decisions.

Health information management is the critical process of acquiring, analyzing, and securing medical information.

What is Medical Coding?

The American Academy of Professional Coders (AAPC) defines medical coding as “the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.” In layman’s terms, it means translating complicated medical information into a widely-accepted shorthand.

Every time you see a healthcare provider, they review your condition, along with your medical history, and determine what they think the issue is and how to treat it. Accurate medical coding of this information is important not only to maintain reliable patient health records, but also to ensure the hospital, clinic, practice, or other healthcare provider receives proper payment.

Why Outsource Medical Coding?

Medical coding is a critical function for any healthcare provider - but it can also be time consuming. That’s why many providers partner with experienced and dependable medical coding companies like LexiCode to handle the task of medical coding, allowing healthcare professionals to focus on patient care.

In heavily-regulated and complex fields like HIM, where compliance is a constant concern, it helps to have dedicated experts in your corner. With over 39 years of coding and auditing experience, LexiCode’s team of seasoned HIM and medical coding specialists help healthcare organizations of all sizes maintain efficient coding practices and improve their coding efficiency while reducing administrative costs.

LexiCode maintains a distributed, global workforce of credentialed coders, which makes them better able to scale up operations in times of heightened demand, and stay productive even in the face of unexpected regional disasters. 

What do Medical Coders do?

Medical coders are the ones who actually do the work of converting complex medical information into predetermined alphanumeric codes, and ensure that these codes are accurate for the medical billing process. In most cases, they’re also responsible for creating insurance claims for the healthcare provider, so accuracy and attention to detail are critical.

According to the Bureau of Labor Statistics, “they might review patient information for preexisting conditions, such as diabetes, to ensure proper coding of patient data. They also work as the liaison between healthcare providers and billing offices.” This access to medical information is part of why medical coders must get special training and certifications before landing the job.

How to Become a Medical Coder

Medical coding is an important role in a highly-regulated industry, so getting hired takes a little legwork. The growing demand and high-value skills you’ll develop make it well worth the effort. In order to become a medical coder, you have to get specialized training and a certification from the American Health Information Management Association (AHIMA).

While getting through the requisite coursework and passing the certification exam may take some time, it’s still considerably less time than it would take to get into other healthcare jobs. Plus, there are many online course options, which can offer more flexibility, allowing you to work at your own pace and when it works for your busy schedule.

Once you’ve completed an accredited medical coding training program, you can take the Certified Coding Associate (CCA) or Certified Coding Specialist (CCS) exam through AHIMA.

To get started on your Medical Coding journey, check out the courses available through LexiCode: https://learn.lexicode.com/

 

In a slightly different twist on our #MeetTheTeam posts, today we’re presenting LexiCode, an Exela Technologies brand providing innovative Health Information Management (HIM) solutions to improve coding quality, minimize compliance risk, and drive reimbursement for our customers. Before joining the Exela Technologies family of brands, LexiCode already had more than three decades of experience enhancing coding operations in all healthcare provider environments. Under Exela’s brand umbrella, LexiCode has the additional leverage of Exela’s innovative solutions and global footprint to rapidly launch new services and optimize existing services.

“Sweets for the suite”

In late September, LexiCode made quite an impact on the AHIMA 2019 Conference in Chicago. AHIMA (American Health Information Management Association) is a leading resource for HIM education and accreditation, professional credentialing, policy-making and issue advocacy. Its annual conference is known as the “premier health data and information event for education and networking” and is always a great place for HIM professionals to learn about the latest trends in the healthcare information space. This year, LexiCode hosted a colorful and delicious “Sweet Solutions” booth—a pop-up “sweet-shoppe” filled with candy and other sweets that turned out to be the place to gather for satisfyingly edifying chat on all things “coding”—earning LexiCode many accolades, including this year’s 2019 Loyalty Appreciation Award.

Why coding requires “critical care”

Success in the healthcare space hinges on comprehensive and accurate coding. Unfortunately, the challenges to effective coding are many, including staffing shortages, inadequate training, and human error. Coding issues cost healthcare providers millions of dollars annually.

LexiCode resuscitates healthcare coding

LexiCode provides coding services and staffing to meet the challenges healthcare coding presents. To ensure that your facility is coding accurately, LexiCode can assist with in-depth analysis and modeling to determine risks and accuracy in coding as well as help your team implement corrective actions. Thousands of providers turn to LexiCode to ensure revenue accountability, coding accuracy, and a proactive approach to staffing. LexiCode’s solutions can be structured as temporary, long-term, or as-needed and address all records types and payment methodologies.

Got questions about LexiCode? Here are some frequently asked questions. Curious about how LexiCode has proven to be a game-changer in the healthcare space? Look no further than the results this hospital enjoyed as a result of partnering with LexiCode.