Outsourcing some HIM functions is common at many organizations. The decision might initially be spurred by staffing shortages or budgetary concerns, but many outsourcing arrangements become long-term projects.
Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
Many HIM directors and coding managers say it takes all three to recruit high-quality, experienced medical record coders post-ICD-10. While coder shortages are nowhere near what they were in ICD-9, new challenges have emerged for HIM staffing.
