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Our Accurate Medical Coding Leads to Amazing Increase in Collections

Based in the U.S, Managed Outsource Solutions is a leading provider of accurate, reliable and timely medical coding outsourcing solutions. We provide these solutions for a variety of medical specialties including pain management, internal medicine, allergy and sleep medicine, gastroenterology and cardiology.

The client this time is a medical billing company located in Kentucky. They provide medical billing services for various specialties such as Internal Medicine, Pain Management, and Cardiology. They serve clients all over the United States.



Challenge

Although the company was experienced in medical billing, collections and revenue cycle management, they did not have adequate coding expertise required to gain maximum reimbursement. They approached us with the requirement of reviewing their clients? medical records and providing coding service for various providers nationwide.

Solution

We gave them a quality, cost-effective solution. We put together a team of AAPC certified coders with extensive experience in the various specialties involved. We also entrusted a project manager with the task of overseeing the production and process. We organized weekly meetings to review coding quality and make certain that all protocols and expectations are met.

The client first scanned and uploaded to our FTP, a trial of 3 charts which were previously coded by the providers. We followed the coding requirements specific to the provider?s locality and provided all linked ICD-9 and associated modifiers needed for proper billing. We returned the coded file by way of a spreadsheet.

Outcome

The client was pleased with our performance for the trial and further projects. Upon return of the completed trial project, the client was very happy to see that we not only coded correctly but also identified some issues that could have a direct impact on the providers? revenue. We discovered that there were many cases of providers under-coding procedures. Under-coding not only reduces reimbursement but can also send a red flag to the payers which can initiate an audit. We also provided guidance when there was a lack of medical documentation in the chart, and cross walked codes depending on the insurances being billed. Our AAPC certified coders are well-versed in federal and commercial coding guidelines.

Outsourcing the coding positively impacted the business as well as the clients it serves. Among the benefits gained were that the client saw 50% increase in collections billing within the first three months, coding was accurate within 99 percent after the first two months and rates were economical. Thus, MOS now has one more name in its long list of satisfied clients.

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