Medical Coding Outsourcing
The CMI Group is a top provider of medical coding outsourcing for health systems, hospitals, clinics, and private practice. As a flexible partner, CMI provides temporary, long-term, supplemental, or complete solutions for all account types and reimbursement methodologies.
Coding Challenges
With new treatments being developed each year, medical coding has not gotten easier. In fact, medical coding has become very difficult and expensive for a business office to handle on its own. The most prominent issues facing providers today are:
1. Staffing
Recruiting and managing medical coders can be a major headache. The job market for coders has never been more competitive, and so it has become a significant challenge to find qualified and credentialed resources. While recruiting has become more difficult across the board, some geographical regions are especially problematic. Even if you can fill coding positions, turnover can leave you back at square one.
2. Guideline Changes
There have been significant coding changes in recent years. Beyond the CMS changes, each third-party payer has developed its own unique coding intricacies. Medical coders who have not kept up with changing guidelines are met with denials and low reimbursement.
Outsourcing Benefits
If you struggle to recruit and manage coders or keep up with changing guidelines, it may be time to consider an outsourced solution. Many providers who have turned to outsourcing to relieve their medical coding burden have benefited from:
• Consistent Staffing Levels and Throughput
• Reduced Overhead and Significant Cost Savings
• Improved Clean Claims Rate and Reduced Denials
• Reduced DNFC/DNFB Days and Dollars
• Improved CMI and DRG-Reimbursed Revenue
• More Time for Other Core Administrative Tasks
Outsourced Medical Coding Options
The CMI team can be the medical coding solution provider that relieves your administrative headaches. Whether you are looking for full outsourcing, code auditing, or backlog support, we can offer a solution customized to your unique needs and budget.
Full Outsourcing
CMI offers a full outsourcing medical coding solution on a temporary or long-term basis. Our coders read the medical charts prepared by your providers and assign the appropriate CPT, ICD-10, and HCPCs codes and modifiers. By utilizing a blend of off-shore coders and US-based quality assurance, we offer an unmatched cost-effective service.
Code Auditing
Medical code auditors give an outside perspective and deep insight into how your in-house team performs. An audit can find missed revenue opportunities and also possible coding compliance issues. Partnering with The CMI Group will ensure that your in-house team is coding correctly and consistently.
Backlog Support
Medical coding challenges can cause a vicious cycle of claims backlogs that can be disastrous for your cash flow and can even damage your relationships with patients and third-party payers. Whether the result of staff attrition, software issues, or guidelines changes, The CMI Group can help your business office work through a backlog and get you back up on your feet.
CMI’s Coding Solution
CMI understands the critical importance of medical coding and the expertise required to get it right. Our voluminous knowledge of the codes and modifiers enables optimal and accurate billing. We have everything perfectly aligned to the goal of supporting your practice as a seamless back-office extension, including:
1. A Strong Foundation
We hire credentialed professionals experienced in inpatient, outpatient, clinic, and professional fee coding. Building upon previous work experience, our medical coding staff undergoes a comprehensive training curriculum upon onboarding and continually, including:
- System(s) and usage
- Payer-specific requirements
- Compliance requirements
- Updated guidelines
2. Speciality Specific
We can support the full range of medical specialties and will assign coding resources experienced in your medical specialty. Our team has distinguished expertise in:
- Oncology
- Cardiology
- Allergy / ENT
- Pediatrics
- Orthopedics
- Physiatry/ Physical medicine
- Infectious Disease
- Ophthalmology
- General Surgery
- Gastro
3. EMR Experienced
CMI pairs your business office with coding resources experienced in your billing system. We can work with any in-house software you use. So whether you use Athenahealth, eClinicalWorks, Epic, Cerner, McKesson, AdvancedMD, Kareo, or another platform, partnering with us will feel like business as usual, but with cleaner claims and fewer headaches.
4. Centralized Operations
Our team specializes in medical coding workflows and has developed consistent, centralized processes. In addition, our processes are enhanced by electronic systems and automation that minimize errors.
5. Quality/Compliance Program
By following strict compliance and quality standards, CMI delivers a 95% average clean claim rate. Every claim is reviewed before submission to ensure compliance and maximum reimbursement.
6. Data Security
Providing critical assurances, CMI’s external audits verify our compliance with all required data security laws, regulations, and standards, including:
- HIPAA
- PCI-DSS
- SSAE18 SOC 1 and SOC 2 Type II
To ensure your continued compliance, our staff receives thorough HIPAA training, ensuring they follow security protocols. In addition, we work closely with you, following all regulatory guidelines regarding data ensuring it is protected when utilized.
Connect with Us
If you need a hand with medical coding, then click below to see how CMI can help you simplify administration and save money:
