Page 3 - Offshore BPO Coding Case Study.indd

Costs
Costs became an unavoidable issue when Canopy added a large hospital-based radiology group to their client list in 2014. Conservative estimates revealed a need to add three additional in-house coders to support the NLS service used at the time. Canopy Partners looked at three offshore BPO companies and found the quality and cost savings with Infinx superior. Annual savings in 2014 exceeded $136,000 with Infinx versus the NLP provider.
Cost Analysis:
12-month savings between Infinx and two competing BPOs
12-month savings Infinx over NLP (prior to 2014 volumes)
Provider Type
Offshore BPO #1 Offshore BPO #2 Infinx BPO
NLP Provider
$25,000+ $54,000+
12.4%
23.1%
IS OFFSHORE CODING SECURE?
Security is a concern for all healthcare providers. Problems related to security around offshore staffing and transmittal have largely been addressed by repu- table BPO companies. Canopy Partners screened many outsourcing providers before forming a relationship with Infinx, an India-based partner. Multiple layers of quality checks and a solid service level agreement are in place to ensure Canopy’s clients are not giving up security, compliance, or quality for cost efficiency.
Canopy Partners uses Merge Financials Practice Management (PM) system. Merge Financials’ servers run on a mul- tiple host cluster to ensure redundancy. All data resides on a Storage Area Net- work (SAN) that is backed up daily.
While productivity outside the Merge Financials system is slightly lower, Canopy clients have a choice of sending their reports directly to Infinx via secure HL7 ORU report file submission. An HL7 charge interface is returned and loaded into the client PM system.
Efficiency - Turnaround Time (TAT)
Projected Total Annual Cost
$218,000 $224,000 $149,000 $330,000
With the NLP, Canopy reports were first loaded into an internal PM system, including demographics, and sent via secure FTP. Reports uploaded and were run through the NLP system for CPT and ICD-9 coding. This back and forth movement added up to 36 hours in TAT for an average 48-hour TAT from beginning to charge post.
With the offshore BPO Infinx, coding takes place within the Canopy PM system the same day reports are loaded. This enables a 24-hour TAT.
Accuracy and Compliance
ICD-10 implementation arrived in October 2015. ICD-10 contains 68,000 codes. The additional codes will reportedly enable greater spec- ificity when creating claims forms on patient care. Coding compliance, and thus payments, hinges on accuracy and completeness.
Claim-edits take an average 20-hours per week for many practices.
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