Inside Angle
From 3M Health Information Systems
Offshore medical coding: Could it be the right fit for you?
Offshore medical coding can be a solution for healthcare organizations that has been overlooked because of previous misconceptions. Let’s examine some of the areas of concern and the questions you may have.
Security and Privacy
One of the largest concerns around offshore coding is regarding security and privacy. How is my data being protected? Are offshore coders being held to the same standards as coding professionals physically located in the United States? The reality is that all coders handling PHI should be trained in HIPAA standards, but how their employer sets the stage for compliance is worth discussing.
When evaluating offshore vendors, you will need to request their standards for security to take a deeper look at their security and privacy policies. What security certifications and accreditations do they maintain? Beyond policies and employee training, what physical safeguards are in place? For example, are USB drives and printing disabled or are cell phones allowed in the workplace? Coders accessing remote charts should be accessing client systems via secured connections such as VPNs or Citrix connections. While many domestic coders work remotely, many offshore vendors require coders to work inside a physical office building to ensure privacy measures are maintained.
Quality
If the vendor is located outside the U.S., will quality standards be lowered? The answer should be “Absolutely not.” When it comes to coding, quality is key and that should not be sacrificed with any coders, whether they are in house, outsourced locally or through offshore coding. A quality program needs to be in place regardless of the location of the coders. Verifying that a quality department or team is established and holds coders to high standards is an important part of early conversations with an offshore vendor. A key component of quality is requiring credentialed coders to be placed on your account. Requesting coders’ credentials and verifying those are held through a reputable organization such as AHIMA or AAPC is not unreasonable. This sets a baseline of standards for quality professionals that will be working on your patient records.
Flexibility
After addressing concerns around security, privacy and quality, think about the reality of dealing with a team halfway around the world. What impact does this bring to your department in terms of turnaround time and communication responses? With the blended approach of an account management team based in the U.S., communication can flow through one point of contact and responses to quality or coding questions can be returned during standard operating hours. While your department and the local account manager are managing business concerns, the offshore coders, working ahead of U.S. time zones, can code charts with a faster turnaround time. They can provide coverage during major U.S. holidays when many staff take lengthy leaves.
With some additional research and by asking the right questions, offshore coding can prove to be the right fit for your organization.
April Lyle, PMP, is project manager with 3M Health Information Systems.
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April Lyle
Project Manager
April Lyle, PMP, is project manager with 3M Health Information Systems and has worked in healthcare for the past 15 years with various roles in coding, software implementations and most…
I suggest that any organization looking to offshore its medical transcription or coding work ensure a vigorous on-site quality assurance program is in place at your institution. Do not rely on the outside organization’s QA. I work for a large healthcare organization in healthcare documentation quality and can attest that offshore transcription is significantly less accurate than that produced by the same on-shore vendor. We were able, through our own random-QA program, to document in a finite numerical manner that the number of critical errors from offshore workers was much higher. In addition, I’ve noticed a very high rate of turnover among the workers at the offshore organization. We were eventually able to get our management to return much of our work to the onshore crew with a substantial improvement in quality. It’s been my experience that few healthcare institutions have retained enough qualified healthcare documentation personnel to be able to do intensive and regular QA on the outside provider’s work. I hope that the coding industry can learn from the healthcare documentation profession’s experience in this situation. ALWAYS ENSURE INTERNAL QUALITY AUDITS!