The U.S. healthcare providers have been using the offshore medical coding from the last 10 years. The healthcare market dynamics is paralleled by its benefits and relevance. Previously, there were offshore developers who were good in quality and works at comparatively lower rates than the domestic developers for offshore development. Now it has seen that offshore developers are less experienced, less reliable and more expensive. In addition to that, availability of the quality onshore developers has increased. How it has determined and where it may go further is discussed here.
Earlier, the radiology and physician group were the majority users of the offshore coding. They were seeking to save the costs for relatively repetitive and simple coding functions. In 2012, executives of the health care began to observe the cost savings to balance the looming cost of ICD-10 preparation. Salary was one of the factors. Advantages of the staff employees could easily be minimized by employing the offshore coding. To find the international partner was the challenge for vendors of domestic coding. A rise in demand for the offshore coding services has started to be experienced by the coding companies.
In 2013, an industry of the U.S. healthcare has moved closer to the ICD-10 implementation. And in 2014, again by the reduced developer productivity, executives of the healthcare realized that the available domestic code was not enough to prevent the huge backlogs of the uncoded charts. In 2015 and 2016, offshore coding has been used unknowingly due to the cash-flow worries, possible interruptions in the revenue cycle and the lower cost. With the coding support for diagnostics and the professional fee coding, offshore companies were also charged with inpatient cases, ambulatory surgery and more complexed emergency rooms.
In contrast to the implementation of the ICD-10 in other countries, the productivity of the U.S. developer which was brought down by half, immediately followed the ICD-10 implementation on 10-Jan-2015 and recovered rapidly. This was possible due to the high expenditure by the providers to improve the workflow infrastructure and applications. Plus, the community of the U.S. Health Information Management took the step and come over with a large scale advanced-training efforts.
Every Developer Is Different
Offshore developers are either well-educated candidates or former nurses. Even when the staff of offshore coding is highly intelligent, they are not trained in chart interpretation. The capability to the self-interpret documentation of this staff in the medical field is low and it results in frequent coding errors. When any offshore company onboards the new developers, they preach them for a month or two and then let them do the on-job training which was followed by live productions. This process is in the contrast to the developers in the U.S. where they are expected to do at least 3 years training to be accurate and productive.
Advantages And Disadvantages Of the Offshore Coding
Cost or Price:
Although the offshore coding is less expensive, but the domestic developers have improved the productivity of ICD-10 and because of that, pricing gap is much small. Companies are not paying a premium for the limited supply of the domestic developers for offshore development.
Other factors of cost differential are the increase in denied claims which has to be reworked, the smaller level of reimbursement received due to the poorly coded claims and the increased amount of inspection on offshore coding that would help to prevent billing errors. By adding all these factors, the cost saving of the offshore evaporate quickly.
Staffing
Large population of the offshore coders/developers was proved valuable in the throes for the implementation of the ICD-10. The executives needed extra coding staff to help them to take care of their business while they were bringing their developers. Offshore developers were able to handle repetitive and basic charts, thus it releases the domestic developers to make the ICD-10 productive on time-consuming and more complex charts.
Efficiency
Because of the time zones, developers are able to send records to be coded offshore in the U.S. at the close of business and also get results back on the next day when business starts. There are many coding questions on payer requirements, coding policies and documentation issues arise in real time while the coding is performed. But this time zone makes the communication on this important question difficult and sometimes impossible because coding would be done without any clarification.
Conclusion
Offshore development has served its purpose in the U.S. market. This has helped the companies while the ICD-10 conversion and supporting the cost crunch in basic charts and routines for offshore development. Now it is a different domestic field.