Page 2 - Offshore BPO Coding Case Study.indd

Healthcare Practices Must Control Costs While Ensuring Accuracy and Compliance
Problem
Coding is integral to healthcare business. ICD-10, moves toward “value-based” healthcare, dropping insurance profitability,
and increasing government management of protocols and reimbursements has increased complexity.
The traditional practice of staffing in-house coders has become cost prohibitive for many providers. The move to NLP, once thought a
cost effective and accurate alternative to live coders, does not always deliver on the three factors all healthcare practices must address: cost, compliance accuracy, and turnaround time (TAT).
With advances in security as well as coding expertise, Business Process Outsourcing (BPO) companies are providing effective alternatives.
Canopy Partners moved from a NLP provider to a BPO in 2013. In the first year, diagnosis coding accuracy increased by 18.6 % and CPT accuracy increased by 2.4%, with annual savings exceeding $136,000. This represented a nine-cent savings per report.
Why Canopy Partners Works with an Offshore BPO Coding Provider
Implementation and Results
As Canopy Partners increased the size and scope of their radiology provider client base, the volume of reports also increased. Canopy had already made a decision to move away from all in-house coding, but maintained three in-house coders for quality control. Yet, rapidly rising costs and compliance with the NLP provider caused concern.
As a matter of best management practice, Canopy commissioned an external coding audit with Claudia Murray, a national consultant. They found detectable levels of incorrect ICD-9 coding.
Combined concerns over cost, accuracy, and compliance led Canopy Partners to take a closer look at Infinx, an India-based BPO provider.
CANOPY PARTNERS MOVED FROM A NLP PROVIDER TO A BPO IN 2013. IN THE FIRST YEAR, DIAGNOSIS CODING ACCURACY INCREASED BY 18.6 % AND CPT ACCURA- CY INCREASED BY 2.4%, WITH ANNUAL SAVINGS EXCEEDING $136,000. THIS REPRESENTED A NINE-CENT SAVINGS PER REPORT.
1331 N. Elm Street, Suite 200 | Greensboro, NC 27401 | 336-274-9617 | canopy-partners.com 2