Essential Requirements for Medical Coding Vendors

There was a great article in June’s edition of For the Record Magazine detailing how medical coding vendors and healthcare organizations can build lasting relationships.¬† All in all, PRN Funding feels that well-written articles like this one show how much the outsourced medical coding industry has grown, and we’re pleased to see it happening so fast.

We summarized some interesting observations from the article for our medical coding service owners and medical coding consultants below.  The article can be viewed in its entirety by clicking here: Seal the Deal.

The need for outsourced medical coding vendors arises when…

  1. There are long-term (one or more positions is open for three or more months) medical coder vacancies.
  2. There is an abnormal increase in discharged not final billed (DNFB) records.
  3. There is a need to cover regular medical coders when they are out for vacation, illness or maternity leave.
  4. There are seasonal spikes that cause more hospital visits and coding backlogs.
  5. A facility is having a hard time recruiting and retaining qualified medical coders or if there is a persistent¬† staff shortage.New medical coding guidelines, such as the Present on Admission’s (POA), are issued.

When selecting a medical coding vendor, healthcare institutions look for…

  1. Medical coders who are both certified, have at least two years of experience and be reliable.
  2. Medical coders who have professional liability insurance.

Some questions a healthcare facility may ask a medical coding vendor include:

  1. What are the pricing guidelines for contracted medical coding services?
  2. How does the medical coding vendor plan to perform quality checks?
  3. Who will perform the quality checks?
  4. What steps need to be taken to ensure records are coded accurately?
  5. How will the facility make sure patient records have been coded correctly using internal guidelines?


Some qualities medical coders need to make a successful transition to working for a vendor are…

  1. Be able to work independently and make independent decisions.
  2. Be flexible and able to adapt to change easily.
  3. Have a strong motivation to find work and a designated work space if working from home.
  4. Have a willingness to learn.


For medical coding vendors to stay at the top of the profession, they should…

  1. Develop and maintain a Web site.
  2. Ask facilities where you have worked to give a testimonial to include in marketing materials.
  3. Print business cards and network.
  4. Attend local, regional and state medical coding meetings, such as the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC).

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