CASE STUDY

Blended Shore Coding Model at a Leading Healthcare Provider

Background

A leading healthcare provider, renowned for its 950+ bed facility and status as an academic trauma one center, has been expanding due to the closure of other local hospitals. With the recent addition of a new 20-bed inpatient rehab facility, the provider continues to grow and adapt to the increasing healthcare demands of the region.

Challenge

Nearly a decade ago, the healthcare provider faced significant challenges in hiring local coders who met their high standards, and when they could, the cost was prohibitively high. This led to a pilot program that sought an innovative solution to their coding needs, balancing quality with cost-effectiveness.

Solution

e4health stepped in with its Blended Shore Coding Approach, a unique solution that combined the cost benefits of offshore coding with the quality and oversight of onshore management. The approach was designed to be flexible, scalable, and tailored to the provider’s specific needs, allowing them to maintain a high level of coding quality and productivity around the clock.

Key components of e4health’s solution included:

  • Strategic integration of offshore coding expertise with onshore management and quality assurance.
  • Development of a second-level review process using tools like Vizient and Smart to ensure compliance and accuracy in coding queries.
  • Provision of continuous education and training to support the high acuity and complex medical procedures unique to the provider.
  • Optimization of the revenue cycle, achieving leaderboard status for the lowest number of coding days, thanks to the round-the-clock coding capabilities.

Expanded Details

The e4health Blended Shore Coding Model is not just a service; it’s a partnership that grows and evolves. The program begins with a detailed planning phase, where e4health works closely with the healthcare provider to understand their specific needs and goals. This is followed by a cautious launch, where the initial offshore team is introduced and closely monitored for quality and compliance. As confidence in the program grows, the team is expanded, always with an emphasis on maintaining the highest standards of coding accuracy and efficiency.

e4health’s approach to coding is proactive and forward-thinking. With the anticipation of increased automation and a focus on clinical data integrity, they are continuously adapting their methods to stay ahead of industry changes. Their coders, rigorously screened for their expertise and experience, are not just coding professionals; they are healthcare advocates dedicated to ensuring the best clinical and financial outcomes for patients and providers alike.

The success of e4health’s Blended Shore Coding Model is evident in the numbers. With external third-party auditors consistently finding that their coding programs exceed 96% accuracy against every quality standard, the healthcare provider can rest assured that their revenue cycle is in capable hands. The partnership with e4health has led to significant cost savings without compromising on quality or productivity, exemplifying the brand’s commitment to empowering better health through innovative healthcare solutions.

Did Your Offshore Coding Go Wrong? New Blended Shore Approaches to Consider

The low availability and high cost of experienced coders is a known challenge. Stiff competition for coding talent is leading many hospitals and health systems to look offshore for the coding workforce they need. This eBook defines five reasons offshore coding goes wrong and provides new best practices for successful blended shore medical record coding programs.

How Can We Help?

For more information on e4health’s Blended Shore Coding Approach and to explore their full range of services, visit e4health Blended Shore Coding. To learn more about e4health’s full suite of solutions and how they can accelerate your organization’s goals, visit e4.health.