In-house or outsource? 10 thoughts on what your practice should do about coding

Practices have a variety of options when it comes to coding. Diagnostic Imaging published an article highlighting the benefits of coding in-house versus outsourcing coding.

Here's what you should know:

1. Accountable Care Options CEO Richard Lucibella advises practices to base their decision on panel size and composition. He said practices should consider caseload, payer mix and pay-for-performance involvement before making a decision.

For example, Mr. Lucibella said single-specialty practices involved with fee-for-service reimbursement can stick with in-house coding if periodic training sessions are held.

2. However, if coding gets more intensive — like requiring functional status, cognitive ability and self-care reporting — external coding may be better.

3. American Academy of Family Physicians' Coding and Compliance Strategist Barbara Hays believes in-house coders improve communication and education in an office. Ms. Hays also believes an in-house coder has a better understanding of the practice than an outsourced coder.

The downside of an in-house coder is rooted in salary. A coder's average annual salary is $49,872. Mr. Lucibella also added employee benefits, service disruptions during vacations and sick days, turnover rates and space requirements to the potential drawbacks.

5. For a practice looking to create an in-house coding team, Ms. Hays suggests looking for individuals with certified professional coder titles. For family medicine, she suggests bringing in someone who is a certified biller.

6. Outsourcing coding also has its potential benefits and drawbacks.

When a practice outsources its coding, it can do so knowing the coding agency is usually more current on coding changes. External agencies also provide services during non-business hours and can offer part-time assistance when needed.

7. Ms. Hays recommends using an outside firm for short-term assignments, like when a practice is transitioning between employees.

8. Mr. Lucibella recommends asking an agency about its training and its turnover rates. He adds practices should find out who is assigned to their practice and ask the coder about their background information.

9. Ms. Hays also recommends asking for reference, when possible, to find out what other practices thought of the coder's work.

10. Ms. Hays said, "If you do choose to outsource, monitor the submitted codes. It might be beneficial to hire a consultant periodically to review charts to make sure claims are being coded and submitted compliantly."

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