Picking the Right Coding Vendor

Picking the right coding vendor can be challenging.  There so many options and they all tell you they offer accurate coding to ensure revenue optimization and compliance risk minimization.  To help you select the right coding vendor, we have compiled some considerations to help narrow down your decision.

Always ask if the codes that they use are specialty specific.  Generalist coders are unable to provide the most accurate coding possible and some multi-specialty coding vendors have coders working across multiple unrelated specialties.  The best multispecialty coding vendors only utilize specialty specific coders and will not let their coders handle materials they are not only unfamiliar with but also do not have the requisite experience in.  It is also important to make sure that specific coders will be assigned to your account, this helps ensure that if there are disputes or disagreements coders can be held accountable for their work.

Additionally, it is wise to ask about their hiring criteria.  Look for answers that stress single specialty experience.  Just as important is whether or not the vendor is validating the caliber of the coder.  This is primarily done in two ways: 1) prior to the engagement of the coder by the vendor, testing them up front to see that they have the requisite skills to code in a particular specialty irrespective of their job experience coding in that discipline, and 2) ongoing coding audits of the coders to validate that they are maintaining their proficiency in that specialty.

Of great import is to ensure that there is a contractual guarantee that all coding work is performed in the USA.  Offshore coding opens the group up to both accuracy and privacy/security issues.  We have also seen companies pull a bait and switch on their clients for vendors that operate a mixed model of possessing both onshore and offshore coders.  They have US based coders to handle dispute, questions, and customer service, but they will send the bulk of their day-to-day work offshore.  Getting a contractual agreement stating that all coding work is US based provides you as the client with more control and greater sense of security that the coders performing work for you are the ones you wanted when you selected the vendor.

These considerations are not all inclusive but should allow for a solid foundation for your coding vendor search.

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