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Medical Coding

Medical Coding: Health Information Management

Professional (Physician) Coding

Physician practices often rely on uncertified coding personnel to complete their coding duties with the intention of keeping costs down. This can be problematic because of the complexities related to medical coding. Often times, this hurts practices in the long-run through high denials rates and decreased reimbursements.

Sutherland has helped a wide variety of specialty providers (including but not limited to orthopedics, vascular, neurology, gynecology obstetrics, emergency room radiology, cardiology, and more) with their coding needs. Our certified coders ensure claims are quickly approved and correctly paid in full the first time, helping physician practices to both improve reimbursements and reduce costs.

Facility Coding

Facility medical coding is becoming increasingly tough. On top of that, to find well-trained hospital facility coders is a tedious and demanding process. It’s no wonder the industry is plagued with rapidly increasing costs.

Sutherland helps facilities handle their coding needs by leveraging first-class, certified coding talent from across the globe. Our services help facilities improve turnaround time, increase quality scores, and grow their bottom-line.

Charge Capture

Accurate and efficient charge capturing is a crucial part of the revenue cycle process. Without a reliable charge capture process, healthcare providers often capture incorrect documented information, poorly-coded claims, and cost themselves immense amounts of money with decreased reimbursements.

Sutherland will digitize and improve the charge capture process for healthcare providers. Our robust and accurate processes help healthcare providers save time and resources. The end result is improved collections, decreased operational costs, and a reduced chance of being audited.

Medical Necessity Checks

Medical necessity denials are some of the most common but complex reasons for claims denials. Especially if improper front-end processes were performed, the resources necessary to investigate and correct a medical necessity denial can be costly for even the largest of healthcare providers.

Sutherland partners with healthcare providers to document medical necessity for treating a patient’s medical condition. We perform medical necessity checks and then take a holistic look at our clients’ end-to-end processes to create automated processes that accurately document and handle the medical necessity documentation.

Pre-Bill Edits

Pre-bill edits can help healthcare providers proactively prevent coding denials. It sounds great in theory, however, many providers struggle with implementing this mid-cycle process. This leads to increased costs, increased claims denials, and decreased reimbursements.

Sutherland’s pre-bill editing services help healthcare providers proactively fix potential claim edit issues. Our team of certified coding specialists look at the entire medical coding process to improve pre-bill services. The end result is increased claims quality scores, improved turnaround times, and, most importantly, a higher collections rate.

Clinical Documentation Improvement (CDI)

Complete and accurate medical record documentation is crucial to the overall success of all hospitals and physician practices. High-performing healthcare facilities and providers make it a priority to implement effective CDI programs to increase their medical records reliability, minimize incomplete documentation, and enhance overall patient care and experience.

Sutherland’s in-depth CDI services help healthcare providers enhance their documentation and mitigate risks. No two hospitals or physician practices are the same, which is why Sutherland customizes each CDI implementation around our client’s specific needs to create the best CDI solution possible.

Coding Audits

To become a quality-driven, value-based healthcare organization, healthcare providers need accurate and complete clinical documentation within their medical records. The best way to know and improve the quality of clinical documentation is through coding audits. Coding audits specifically target and review diagnosis and procedural code selection, as well as abstracting as determined by the physician documentation within each medical record.

Sutherland provides comprehensive coding audits. Our certified auditors investigate areas of weakness and then work with our clients to identify opportunities for training, education, technology improvements, and process transformation that improves overall coding audits.

Provider Education

Medical coding is incredibly complex and keeping staff updated on all its nuances is both timely and costly. Healthcare providers need to implement or improve their provider education programs so they can improve documentation habits for accurate, compliant coding and improved reimbursements.

Sutherland is a trusted source for provider education programs. We bring in our certified coding experts to provide the most up-to-date curriculum and ensure our clients’ educational objectives are soundly met. These services keep healthcare providers educated and help ensure maximized reimbursement throughout their coding operations.

Coding Denials

Denials are a major part of the healthcare provider’s world. Even the very best coding teams will eventually face the issue of handling coding denials. The concern is when coding denials rates happen with a higher frequency over time or within certain circumstances.

Sutherland provides coding denial services to help healthcare providers handle their denials backlogs and proactively prevent future denials. Our certified coding experts help to fix small but important issues, resulting in improved claims quality and increased reimbursements.

The impact (value, savings)
  • Increase revenue with >95% guaranteed quality scores and dependable turnaround times
  • Cost savings through global delivery model and outcomes-based pricing
  • Sutherland never uses subcontracted employees, only our own, fully-certified coders
Our experience
  • 10M+ charts coded annually
  • 800+ dedicated coders
Who we help
  • Large to small health systems
  • Level 1 trauma centers
  • Teaching hospitals
  • Physician practices
  • Specialties include inpatient diagnosis-related group (DRG), ambulatory surgery, emergency department, ancillary, radiology, and clinic visits
Our differentiators

Combination of people, process, and technology

If any part of this combination is weak then coding operations become inefficient. Sutherland invests in our employees’ continuous learning, transforms outdated processes, and leverages a blend of third-party and proprietary technologies to create a best-in-class offering for our clients.

Dedicated compliance team

Medical coding is a constantly changing and evolving practice. To ensure our services and our clients remain fully compliant to federal, state, and industry regulations, we have a dedicated compliance team who helps standardize operations across our geographies and share all upcoming mandates and regulations.

Coding talent acquisition

At Sutherland, we use no sub-contracted medical coders for the services we provide to our clients. Our employees are credentialed, continuously educated on coding changes, and bring years of experience. Combine this with our blend of best-in-class technologies, we are able to transform medical coding into an art.

Opening/Introductory

Coding has undergone a major transformation the past few years with the influx of new patients, ICD-10 finally going live, and the digital health era becoming more ingrained in healthcare’s operations. Hospitals and physician practices are under pressure to quickly revamp their departments to meet these changes and to proactively prepare for future ones.

Successful coding operations are about finding the best people and giving them best-in-class tools to succeed. Coders need to be credentialed, continually educated on coding’s changing landscape, and provided with the best industry tools and proprietary technologies to perform highly in their role.

At Sutherland, not only do we improve quality and turnaround times for coding operations, we also help hospital and physician practices transform processes so they can create more scalability and a higher-performing coding department that can succeed in healthcare’s new digital era.

Our work (Case studies)