Medical Coding Outsourcing – The Need and Benefits

Is your medical coding process prone to issues like poor documentation, use of outdated code sets and a failure to handle volume spikes? Do your staff constantly feel burned out from the pressures of maintaining accuracy and dealing with tight deadlines? It’s certainly not an easy job to deal with 1,20,000 (ICD-11) medical coding terms.

Of course, in-house employees are top contributors to thriving medical practices. Having said that, it’s challenging to constantly keep up with dynamic healthcare industry trends, especially for medical coding professionals.

So, here’s a comprehensive answer to the question – should I outsource medical coding? In this blog, you’ll discover both the need and benefits of medical coding outsourcing.

Outsource Medical Coding

Medical coding outsourcing is no longer a luxury. Fortunately, it has become mainstream for healthcare businesses of all sizes.

Outsourcing allows you to generate greater results and save costs. It does so with technological advancements, streamlined processes, economies of scale, subject matter expertise and much more.

Given today’s competitive marketplace, a meticulously managed coding process can help healthcare organizations gain a strategic edge. Medical coding outsourcing makes this possible and acts as a tool to broaden business benefits. Outsourcing service providers are responsible for timely delivery. When you outsource to medical coding companies, they provide coders who are versed in the latest industry trends and possess necessary skills.

Outsourcing allows healthcare setups to have complete ownership and control over medical coding processes. It allows hospitals to focus on quality patient care and maintain viability in the longer run. A service provider can offer consistency and control costs in instances of patient volume-spikes, fluctuating staff levels, etc.

Now that we’ve clearly established the need, let’s look at the advantages of outsourcing medical coding.

Outsourcing Medical Coding Advantages

Before taking the plunge, you must determine if you’re keen to outsource medical coding to scale your business. For this reason, we’ve listed several benefits of outsourcing medical coding below.

Latest Coding Certification

Medical coders should stay abreast with the latest coding sets and best practices. They must also have the latest certifications and required educational qualifications. Government agencies, healthcare institutions and groups release coding updates on their websites. Coders must also follow these updates regularly.

A lot of time and hard work goes into getting certified and staying up to date with coding trends. An outsourcing provider makes sure that their coders comply with all the above requirements. Every coder assigned to you will have the required knowledge, skills and certification(s).

Note: Look out for American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) certified coders.

Ability To Tackle Volume Spikes

Medical practices rely fully on their in-house medical coding teams for coding needs. However, these teams have limited adaptability with regards to changing conditions. For instance, sometimes the capacity of the in-house coding team may not meet the volume of coding assignments. At other times, the team may be short-staffed when a member is on leave or falls sick. All these challenges result in backlogs and delayed turnarounds that affect your bottom line.

Outsourcing agencies are equipped to handle these, among other issues. They can increase or decrease the number of coders depending on the volume of work you assign. Leave and ill-health are never an issue as these agencies can easily substitute coders.

Cost Efficiency

According to AAPC estimate, the average annual salary of a medical coder is upwards of $50,000. With experience and certifications, this cost can go as high as $64,000 annually. Considering their technical skills, hiring in-house medical coders is expensive in most cases. In addition to paying salaries, you will have to offer employee benefits such as health insurance, annual paid leaves, retirement benefits and much more. Of course, there are intangible costs to consider too, such as hiring, training, licensing, etc. To add to all this, you will have to provide infrastructure and work equipment.

If you instead work with an outsourced partner, all these costs can be efficiently managed. Not only are the operations of a medical coding outsourcing agency scalable, but their only focus is to offer quality coding. For these reasons, outsourcing companies can control costs significantly.

Ability To Focus on Core Business

In-house medical coding is tedious, requires dedicated focus and time. Physicians who have to manage their own coding feel constantly burned out and unable to focus on core business activities as a result.

Outsourcing can solve this problem. You can get more work done in the same amount of time. It also allows you to improve the quality of patient care.

Accuracy and Consistent Quality

Medical coding outsourcing companies offer dedicated, high-quality work. Maintaining accuracy levels is not a challenge with experienced coders with keen auditing skills. Partnering with a coding expert who specializes in your field can ensure that there are fewer errors.

Since outsourcing companies offer flexibility in terms of substituting resources when a coder is on leave, you get the same quality of work without compromising on delivery deadlines.


When you outsource your processes, it is the responsibility of the service provider to share detailed and regular medical coding reports. These reports help determine the efficiency of outsourced processes. They also help highlight and control delays and errors in assignments.

The outsourcing agency defines a set of metrics which governs first-pass payments, denial rates, collections, etc. As a result, you also have immense control over the process.


Compliance related issues put a strain on smaller healthcare providers who often don’t have developed compliance practices. It may be due to a lack of budget to hire a compliance officer. However, this isn’t by any means an excuse to overlook compliance management.

In the case of healthcare setups that cannot justify having full-time compliance officers, outsourcing medical coding process can be a viable option. Outsourcing can also help these businesses re-examine their position on compliance.

24/7 Operational Capabilities

Medical coding professionals have relatively independent roles. They get to exercise a good deal of autonomy as far as completing tasks is concerned. However, several factors such as procrastination, time off and health issues may cause delays or reduced output.

You can leverage 24/7 operational capabilities of medical coding outsourcing agencies to tackle all productivity issues. Depending on where in the world your outsourcing provider is, their coding staff will likely be available round-the-clock to tackle all your medical coding woes (accuracy, compliance, turnaround and much more).

Hopefully you now have a satisfactory answer to the question – why outsource medical coding?

Let HelioNext Empower You

As complex as it may be, medical coding is a vital step in revenue cycle management for healthcare businesses. A lack of coding expertise may result in over-coding, under-coding, errors, fraud abuse, fines, and denial of claim reimbursements.

So, if it is a challenge for you to find good medical coders, outsourcing may be a good option.

HelioNext is the home to AHIMA and AAPC certified medical coders with sound technical expertise. We can resolve all your coding-related worries and enable you to do what you’re best at — providing quality patient care.

Find out more about the pros and cons of medical coding outsourcing. Get in touch with us today.