Signs Your Coding Vendor May Be Creating More Work for Your Team

Outsourcing coding should make your team’s job easier, not create another layer of follow-up, delays and uncertainty.

That was the challenge one home health organization faced before partnering with Advanced RevCycle. More than 60% of the organization’s charts were being placed on hold, appropriate comorbidities were frequently overlooked and the team dealt with unnecessary delays and limited visibility into chart status.

The organization needed more than an outsourced coding vendor. It needed a knowledgeable partner that could improve accuracy, communicate clearly and help keep work moving.

Its experience highlights several signs that a coding vendor may be creating more work for your team instead of reducing it.

1. Too Many Charts Are Being Put on Hold

Some chart holds are necessary. Missing or unclear documentation may require additional information before coding can be completed accurately. But when more than half of the organization’s charts were being placed on hold, often for unnecessary reasons, the process became a source of frustration and additional work for the team.

Repeated holds can require clinical and administrative staff to investigate issues, respond to questions and follow up on charts that should already be moving forward.

After partnering with ARC, the organization saw a more purposeful approach to chart holds. ARC’s coding team focused on identifying when additional information was truly necessary and clearly communicating what was needed to resolve the issue.

A strong coding partner should help remove unnecessary roadblocks while maintaining the accuracy and regulatory focus your organization requires.

2. Appropriate Comorbidities Are Being Missed

Accurate diagnosis coding requires a thorough review of the documentation, including appropriate comorbidities supported by the patient record.

Before working with ARC, the organization found that appropriate diagnoses were frequently being overlooked. As a result, many charts were falling into low or no comorbidity adjustments.

ARC brought greater attention to thorough diagnosis coding and the capture of qualifying comorbidities supported by the documentation. The organization experienced more precise and dependable coding, helping strengthen confidence in the accuracy of each chart.

For other home health organizations, missed comorbidities can be a sign that the coding process is not receiving the level of review and attention it needs.

3. Your Team Has Limited Visibility Into Chart Status

Your staff should not have to send multiple emails or make repeated calls just to understand where a chart stands.

The organization needed greater visibility into its coding workflow and an easier way to communicate with its coding team.

Through ARC’s RCM platform, the team can monitor coding status, communicate directly with ARC and prioritize charts when needed. That additional visibility makes it easier to understand what requires attention and what is already moving through the process.

For the organization, better visibility helped create a more manageable coding experience. For other organizations, it is an important consideration when evaluating whether a vendor is truly supporting the internal team.

4. Coding Issues Are Creating Problems Downstream

Coding problems do not always stay within the coding department. They can create additional work throughout the revenue cycle.

Before partnering with ARC, the organization experienced coding challenges that created unnecessary delays and frustration. Accurate primary diagnosis coding was also an important concern, particularly when it came to alignment with face-to-face documentation.

Since working with ARC, the organization has experienced little to no pre-claim rejections related to the primary diagnosis not matching the face-to-face documentation.

That improvement demonstrates how more precise coding upfront can help reduce downstream issues and prevent staff from having to revisit work later in the process.

5. Getting an Answer From Your Vendor Is Harder Than It Should Be

When questions arise, your team needs access to people who understand coding regulations and can provide clear, timely answers.

Responsive support was an important priority for the organization after previous vendor experiences created delays and frustration.

With ARC, the organization gained access to a knowledgeable account support team that could provide answers and help keep the process moving.

As a member of the organization’s clinical leadership team shared:

“Working with ARC’s team has been wonderful. They are very responsive, easy to work with and extremely knowledgeable about coding regulations.”

That level of responsiveness can make a significant difference. A coding vendor should feel like an extension of your team, not another relationship your staff has to manage.

What Changed for This Home Health Organization

By partnering with Advanced RevCycle, the organization gained a coding process built around greater accuracy, visibility and support.

The results included:

• More thorough capture of qualifying comorbidities
• More precise and dependable diagnosis coding
• Little to no pre-claim rejections related to the primary diagnosis not matching face-to-face documentation
• Greater visibility into coding status through ARC’s RCM platform
• Easier communication and chart prioritization
• Exceptional coding turnaround time
• Responsive, knowledgeable account support

The organization’s experience shows what outsourced coding can look like when the right people, processes and technology are working together.

Your Coding Partner Should Reduce Complexity

Outsourced coding should give your organization greater confidence, visibility and support.

Advanced RevCycle combines experienced coding professionals, responsive account support and technology that gives teams greater insight into their coding workflow. For this organization, that meant fewer unnecessary roadblocks, more dependable coding and a process the team could rely on.

Accurate coding supports more than reimbursement. It can help reduce unnecessary delays, strengthen revenue integrity and give your team greater confidence in every chart.

Ready for a coding partnership that works with your team, not against it? Contact Advanced RevCycle to learn more.