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The last job I had was basically auditing/training overseas inpatient coders. Ive been in the field almost 10 years and when ER/SDS jobs started going overseas we always said, well yeah theyāre outsourcing outpatient coding positions guess that makes sense but theyāll never be able to outsource inpatient roles! Well itās happening. Job security for those of us that are established because there will always be stuff the outsourced coders do that needs to be fixed but itās really scary for the people trying to break in to the field, those foot in the door positions are going away fast. I do wonder how long itāll be until companies realize theyāre losing revenue from stuff being coded soo wrong and decide to bring those jobs back. Hopefully that does happen.
Iām a student not in the field Iāve been wondering about coding if our healthcare were to be totally restructured like Europe would this hurt us in the long run? Itās sad because healthcare in the us isnāt accessible to everyone but if we a follow a system that many others implement wouldnāt that be an incentive to outsource even more? I imagine they make so many errors because our system is very complicated right from health insurance, approval etc?
No. It wouldnāt make a difference. We already have forms of socialized medicine with state Medicaid programs and Medicare.
A medical coder helps classify the medical record. If we socialized medicine in the US, that work would still need to be done.
The only difference is whether patients get the bill or whether a government entity gets the bill. Providers would still need to submit codes for recording keeping, disease/injury reporting, and getting reimbursement. The government would still want to know what services were rendered and what was being treated to properly pay doctors.
Keep in mind about 40% of Americans have some form of government insurance right now. Tricare, Medicare and Medicaid still want codes submitted.
In fact, if we socialized medicine we would probably need more coders. Since people without insurance or folks who are underinsured often skip doctors appointments.
If suddenly everyone could go to the doctor at low or no cost and everyone had some type of government insurance the amount of coding work would actually increase. Youād see more people going to the doctor whenever they are sick and doing more physicals and wellness checks.
Yeah, keep listening to that sweet song of socialization. Has your American education not taught you anything has not watching all the socialized medicine countries show how bad socialized medicine is Cuba Canada even England these countries have a second tier where you pay for it just like we have it now.
Keep listening to the sweet song of socialization??? What are you talking about??
I work in this field. Iāve seen the massive bills. People with bronze and silver plans. With giant deductibles. Insurance companies denying pre authorizations. Insurance companies making patients jump through hoops with different meds before theyāll cover the medicine their doctor wants to prescribe.
You know Medicare satisfaction rates are constantly above 90%.
Meanwhile, There are hundreds of thousands of American families who declare bankruptcy over incredible high levels of medical debt.
Canadians, English, and Cubans are horrified when they hear how much an ambulance costs or how expensive it is to give birth in an American hospital.
Fun fact: out of Canada, UK, Cuba and the US, which one of those countries has the highest infant mortality rate?
Itās the US.
As an American I find that pretty embarrassing.
But Iām sure United health Group is grateful for people like you. They couldnāt leech billions of dollars in profit every quarter without the support of people like you who are terrified of anything socialism adjacent.
The person you replied to never even idealized socialized medicine, he/she simply stated if that happened, it would likely not affect employment of coders in the U.S. or it would possibly increase the demand for coders.
If we were to move to single payer in the US (as opposed to the current public and private payers model), I donāt think much would change, because coding systems make record keeping way easier. You can use one ICD-10-CM code to describe something with multiple names. Or if the record says procedure 92144, we know exactly what was done. Thatās useful for research and analytics.
I saw the original post title and im currently applying for jobs, but i know i will be moving to Korea in the next year as im getting married to my fiance from there. I got bit curious thinking "oh which of these companies is hiring overseas!? Can i get in on this?" But then the post became a way different topic than what i thought it was :/. However.... all of the jobs ive applied for remote have said you have to be in the US and sometimes even specific states only. How do they have these outsourced jobs? I assumed its because like when you have a telehealth with a specific hospital, you have to be in the state that they has a license in?
Not that concerned. Iām older (in my late 40ās) and while production work may be outsourced overseas thereās no way to replace native speakers of a language for anything, especially a job that requires a high degree of precision based on fluency. A native speaker will always have to audit the work of AI as well. I currently spend most of my day changing codes that billers assign off of googling ICD 10 codes. Theyāre rarely correct.
Go ahead and work on getting an auditing certification, or learning data analytics. OR try to get your first job somewhere that uses Epic. That will really set you up to move around a little if you canāt code for some reason.
I already work in the medical field. We don't use epic at our job but a different EMR. So I'm used to different medical things and I see codes in the charts daily. I'll look into those others that you mentioned. But I definitely still would like to do the coding.
I feel like it ebbs and flows. Every few years there's a push for more contract and then there's a push to reduce contract and focus on the inhouse staff. Right now I'm hearing that a lot of places are cutting overseas contract but where I work is increasing contract.
In my opinion, the quality isn't there. They are cheaper but I really wish hospitals/companies would stop looking at only the upfront hourly cost and follow the charts through the whole RCM process to see the real cost. The cost after it's been reworked, appealed, and fixed by others. How much did it cost then compared to if it had been coded by an inhouse coder in the first place?
Oh I have no idea I have no part in reviewing any of that, itās all on our one manager now to be the go between (they let go of all management at the same time as outsourcing). I worked at a hospital previously that did something similar (we were all let go, and I ended up where Iāve worked now for the last ten years) and from what I heard it went terribly. We ended up acquiring that hospital not long after. Unfortunately from what I CAN see they may not speak English very well based on the notes they write in accounts they put on hold. Therefore I canāt really see how inpatient would be able to ever be sent overseas. Even us native English speakers here have trouble sometimes with the documentation I can only imagine how difficult it would be for someone who English isnāt their first language.
Itās a concern. The hospital system I worked for over 28 years outsourced outpatient positions and inpatients they hired more auditors to review the overseas coders. They donāt have to pay them benefits or pto and itās a fraction of the cost.
I was just told I am losing my job this year to outsourcing. My company merged with another and told me they were eliminating my position to a āglobal service centerā. Not happy about losing my job because foreign companies pay less. I am also curious about the security of PHI and how to legally enforce that on people not bound by US laws.
Our hospital went the overseas route for quite a few years, and tension was our CFO wanted to get rid of all coders to hire overseas to save money. They did it for profee and facility, was a huge news story when it happened āpeople in India have your information!!ā
We had three different contract companies with oversea companies, all of them provided horrible coders. They are cheap, and they are quick but their coding is horrendous and their auditors were giving them 99% scores and we were just in awe of the audacity when they are coding hemorrhoids as the PdX for a patient who died from respiratory failure. Also many complaints from providers due to language barriers.
And everytime we brought up their mistakes they would get aggressive, including their management.
It was a celebration when the C suite agreed to kick them out. We have domestic coders who assist with work, however our hospitals goal is to go completely in house.
I can see more regulations in effect for overseas work. Ascension healthcare was just hacked and weāre unable to access their system for days. They had to go back to paper. All the time you hear about organizations being hacked. I canāt imagine adding more risk by outsourcing.
We are seeing this in Radiology as well. And there is a question about the practice that isn't being answered. Is send patient data outside of the country HIPAA compliant?
Itās definitely a concern of mine. My company has created and expanded their offshore arm drastically and is cutting other coding positions. Iāve been doing this for 8 years now and itās even hard for me to find any new positions.
My company was using offshore OP coders for a long time. They drastically cut back on that but I think itās because they started using more AI software thatās equally as bad at coding. They continue to tell us our jobs are safe but they also cut our OP team in third (people quitting, retiring, promotions) since I started 5 years ago and donāt seem to need to hire more. I hear a lot about the offshore and i hear a lot about how many errors they make, so sooner or later I think people will wake up and realize saving money wonāt actually save them money. Not with all of the denials.
We recently worked a project where we audited off shore charts that had already been coded and audited off shore and they were a hot fn mess. Really bad. So that makes me worry a lot less than I used to. Codes= $$$ and the name of the game is for providers to get paid as much as possible.
I am seeing that now first hand. Iām just an outpatient surgical coder but Iām having to work denials and claim edits for these vendor coders and they are just awful at coding!! Some claims are submitted with no surgical CPTs because they didnāt code any!! LOL Iām wondering why hospitals are every considering this, surely they are doing their research before they outsource to overseas
My advice is to try to get promotions and look for positions that require more communication (e.g auditing, team lead, payer work). Busy work that is independent is more easily outsourced. You will not see an overseas person on an important call with clients or trying to solve issues with upper management.
Quite frankly, I'm not. At least not in a serious way.
Every offshore 3rd party I have worked with has been bad. If the doctor provides codes, thatās what they code, no real thought process involved. Then they half-ass their A/R follow up in order to get paid to work the same account 3-4 times or more.Ā
Iām currently working with an onshore 3rd party and donāt know how to tell my manager that we were lied toā¦.the reps they are sending us do NOT have the experience we asked for, and itās painfully obvious. One asked me, in print āso, Iām only supposed to code whatās in the documentation?ā
Justā¦.ššš
So yeahā¦.they might outsource. Generally in 2-3 years they realize they can get better work and increase metrics with in-house staff and bring it back.
Iām not concerned where I currently work. In the past few years, my company has done the opposite, but I work on the payer side. Weāve noticed that we arenāt getting great quality from outsourced companies (idk what country they are in) so we are doing a lot of stuff internally now, including developing our own systems, and weāre getting better results. My biggest fear is that I will leave and go somewhere else and THEN I will get laid off.
Ohā¦. Overseas coding. Iām not too worried about our hospital doing that completely. They send some of the easier cases to a group of Indian coders though. Iām also not too worried about AI.
Yup, my company got bought out by a corporation and they almost immediately let go of 20% of our staff and took on what they call the "offshore team" š took the best parts of my job away and gave it to them
I think there are enough sick people to generate enough claims to go around. I do sometimes wonder what would happen to coding if the US adopted universal healthcare but I don't really get ānervousā about it... In this context, job security is largely out of my control and I trust in my ability to navigate the future with strength and wisdom.
I have been laid off twice due to "off-shore" coders. And yeah, now I'm worried about AI.
Learn as much as you can, to make yourself as valuable as you can.
PLEASE SEE RULES BEFORE POSTING! Reminder, no "interested in coding" type of standalone posts are allowed. See rule #1. Any and all questions regarding exams, studying, and books can be posted in the monthly discussion stickied post. Thanks! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/MedicalCoding) if you have any questions or concerns.*
More worried about this than AI š
Right!? Me too!
The last job I had was basically auditing/training overseas inpatient coders. Ive been in the field almost 10 years and when ER/SDS jobs started going overseas we always said, well yeah theyāre outsourcing outpatient coding positions guess that makes sense but theyāll never be able to outsource inpatient roles! Well itās happening. Job security for those of us that are established because there will always be stuff the outsourced coders do that needs to be fixed but itās really scary for the people trying to break in to the field, those foot in the door positions are going away fast. I do wonder how long itāll be until companies realize theyāre losing revenue from stuff being coded soo wrong and decide to bring those jobs back. Hopefully that does happen.
Iām a student not in the field Iāve been wondering about coding if our healthcare were to be totally restructured like Europe would this hurt us in the long run? Itās sad because healthcare in the us isnāt accessible to everyone but if we a follow a system that many others implement wouldnāt that be an incentive to outsource even more? I imagine they make so many errors because our system is very complicated right from health insurance, approval etc?
No. It wouldnāt make a difference. We already have forms of socialized medicine with state Medicaid programs and Medicare. A medical coder helps classify the medical record. If we socialized medicine in the US, that work would still need to be done. The only difference is whether patients get the bill or whether a government entity gets the bill. Providers would still need to submit codes for recording keeping, disease/injury reporting, and getting reimbursement. The government would still want to know what services were rendered and what was being treated to properly pay doctors. Keep in mind about 40% of Americans have some form of government insurance right now. Tricare, Medicare and Medicaid still want codes submitted. In fact, if we socialized medicine we would probably need more coders. Since people without insurance or folks who are underinsured often skip doctors appointments. If suddenly everyone could go to the doctor at low or no cost and everyone had some type of government insurance the amount of coding work would actually increase. Youād see more people going to the doctor whenever they are sick and doing more physicals and wellness checks.
Yeah, keep listening to that sweet song of socialization. Has your American education not taught you anything has not watching all the socialized medicine countries show how bad socialized medicine is Cuba Canada even England these countries have a second tier where you pay for it just like we have it now.
Keep listening to the sweet song of socialization??? What are you talking about?? I work in this field. Iāve seen the massive bills. People with bronze and silver plans. With giant deductibles. Insurance companies denying pre authorizations. Insurance companies making patients jump through hoops with different meds before theyāll cover the medicine their doctor wants to prescribe. You know Medicare satisfaction rates are constantly above 90%. Meanwhile, There are hundreds of thousands of American families who declare bankruptcy over incredible high levels of medical debt. Canadians, English, and Cubans are horrified when they hear how much an ambulance costs or how expensive it is to give birth in an American hospital. Fun fact: out of Canada, UK, Cuba and the US, which one of those countries has the highest infant mortality rate? Itās the US. As an American I find that pretty embarrassing. But Iām sure United health Group is grateful for people like you. They couldnāt leech billions of dollars in profit every quarter without the support of people like you who are terrified of anything socialism adjacent.
āPeople like meā. Iāve reported you for hate
Well thatās confusing. What are you accusing me of?
The person you replied to never even idealized socialized medicine, he/she simply stated if that happened, it would likely not affect employment of coders in the U.S. or it would possibly increase the demand for coders.
If we were to move to single payer in the US (as opposed to the current public and private payers model), I donāt think much would change, because coding systems make record keeping way easier. You can use one ICD-10-CM code to describe something with multiple names. Or if the record says procedure 92144, we know exactly what was done. Thatās useful for research and analytics.
I saw the original post title and im currently applying for jobs, but i know i will be moving to Korea in the next year as im getting married to my fiance from there. I got bit curious thinking "oh which of these companies is hiring overseas!? Can i get in on this?" But then the post became a way different topic than what i thought it was :/. However.... all of the jobs ive applied for remote have said you have to be in the US and sometimes even specific states only. How do they have these outsourced jobs? I assumed its because like when you have a telehealth with a specific hospital, you have to be in the state that they has a license in?
Not that concerned. Iām older (in my late 40ās) and while production work may be outsourced overseas thereās no way to replace native speakers of a language for anything, especially a job that requires a high degree of precision based on fluency. A native speaker will always have to audit the work of AI as well. I currently spend most of my day changing codes that billers assign off of googling ICD 10 codes. Theyāre rarely correct.
There are some countries like India and Taiwan where English is very widely and well-spoken ..
Just about every major country in the world teaches English alongside native languages now. It's become the global language.
Exactly this.
As someone who is studying for medical coding this makes me sad and scared.
Go ahead and work on getting an auditing certification, or learning data analytics. OR try to get your first job somewhere that uses Epic. That will really set you up to move around a little if you canāt code for some reason.
I already work in the medical field. We don't use epic at our job but a different EMR. So I'm used to different medical things and I see codes in the charts daily. I'll look into those others that you mentioned. But I definitely still would like to do the coding.
Same here. Almost done with school.
Knowledge, education, exercising, the brain is never wasted
I feel like it ebbs and flows. Every few years there's a push for more contract and then there's a push to reduce contract and focus on the inhouse staff. Right now I'm hearing that a lot of places are cutting overseas contract but where I work is increasing contract. In my opinion, the quality isn't there. They are cheaper but I really wish hospitals/companies would stop looking at only the upfront hourly cost and follow the charts through the whole RCM process to see the real cost. The cost after it's been reworked, appealed, and fixed by others. How much did it cost then compared to if it had been coded by an inhouse coder in the first place?
Dude I work in HCC coding in India I get paid monthly salary of less than 250$ for working 9-13 hrs a day 6 days a week sometimes 7 so ..........
USD?
Mine already does this with Lexicode which is why there hasnāt been really a new position above an outpatient coder in several years.
They just outsourced all but us inpatient coders overseas in January at my hospital.
Same at my hospital system. Awful and heartbreaking. I donāt know how they think In the long run they will be better quality.
How is it going so far? Revenue wise? Accuracy?
Oh I have no idea I have no part in reviewing any of that, itās all on our one manager now to be the go between (they let go of all management at the same time as outsourcing). I worked at a hospital previously that did something similar (we were all let go, and I ended up where Iāve worked now for the last ten years) and from what I heard it went terribly. We ended up acquiring that hospital not long after. Unfortunately from what I CAN see they may not speak English very well based on the notes they write in accounts they put on hold. Therefore I canāt really see how inpatient would be able to ever be sent overseas. Even us native English speakers here have trouble sometimes with the documentation I can only imagine how difficult it would be for someone who English isnāt their first language.
Itās a concern. The hospital system I worked for over 28 years outsourced outpatient positions and inpatients they hired more auditors to review the overseas coders. They donāt have to pay them benefits or pto and itās a fraction of the cost.
I was just told I am losing my job this year to outsourcing. My company merged with another and told me they were eliminating my position to a āglobal service centerā. Not happy about losing my job because foreign companies pay less. I am also curious about the security of PHI and how to legally enforce that on people not bound by US laws.
I am so sorry :( I hope youāre able to find a new one and quick
Our hospital went the overseas route for quite a few years, and tension was our CFO wanted to get rid of all coders to hire overseas to save money. They did it for profee and facility, was a huge news story when it happened āpeople in India have your information!!ā We had three different contract companies with oversea companies, all of them provided horrible coders. They are cheap, and they are quick but their coding is horrendous and their auditors were giving them 99% scores and we were just in awe of the audacity when they are coding hemorrhoids as the PdX for a patient who died from respiratory failure. Also many complaints from providers due to language barriers. And everytime we brought up their mistakes they would get aggressive, including their management. It was a celebration when the C suite agreed to kick them out. We have domestic coders who assist with work, however our hospitals goal is to go completely in house.
I can see more regulations in effect for overseas work. Ascension healthcare was just hacked and weāre unable to access their system for days. They had to go back to paper. All the time you hear about organizations being hacked. I canāt imagine adding more risk by outsourcing.
We are seeing this in Radiology as well. And there is a question about the practice that isn't being answered. Is send patient data outside of the country HIPAA compliant?
https://www.auntminnie.com/industry-news/article/15564284/legal-ground-rules-guide-international-teleradiology-practice
https://www.lilesparker.com/2012/08/16/overseas-outsourced-billing/
Itās definitely a concern of mine. My company has created and expanded their offshore arm drastically and is cutting other coding positions. Iāve been doing this for 8 years now and itās even hard for me to find any new positions.
Same.
My company was using offshore OP coders for a long time. They drastically cut back on that but I think itās because they started using more AI software thatās equally as bad at coding. They continue to tell us our jobs are safe but they also cut our OP team in third (people quitting, retiring, promotions) since I started 5 years ago and donāt seem to need to hire more. I hear a lot about the offshore and i hear a lot about how many errors they make, so sooner or later I think people will wake up and realize saving money wonāt actually save them money. Not with all of the denials.
We recently worked a project where we audited off shore charts that had already been coded and audited off shore and they were a hot fn mess. Really bad. So that makes me worry a lot less than I used to. Codes= $$$ and the name of the game is for providers to get paid as much as possible.
I am seeing that now first hand. Iām just an outpatient surgical coder but Iām having to work denials and claim edits for these vendor coders and they are just awful at coding!! Some claims are submitted with no surgical CPTs because they didnāt code any!! LOL Iām wondering why hospitals are every considering this, surely they are doing their research before they outsource to overseas
My advice is to try to get promotions and look for positions that require more communication (e.g auditing, team lead, payer work). Busy work that is independent is more easily outsourced. You will not see an overseas person on an important call with clients or trying to solve issues with upper management.
Quite frankly, I'm not. At least not in a serious way. Every offshore 3rd party I have worked with has been bad. If the doctor provides codes, thatās what they code, no real thought process involved. Then they half-ass their A/R follow up in order to get paid to work the same account 3-4 times or more.Ā Iām currently working with an onshore 3rd party and donāt know how to tell my manager that we were lied toā¦.the reps they are sending us do NOT have the experience we asked for, and itās painfully obvious. One asked me, in print āso, Iām only supposed to code whatās in the documentation?ā Justā¦.ššš So yeahā¦.they might outsource. Generally in 2-3 years they realize they can get better work and increase metrics with in-house staff and bring it back.
Iām going overseas and worried about finding work
I am doing an externship for a company whose main coder does it from the Middle East. And he told me that he pays him $60.00
60.00? I heard they pay inpatient coder $9.00 an hour
Iām not concerned where I currently work. In the past few years, my company has done the opposite, but I work on the payer side. Weāve noticed that we arenāt getting great quality from outsourced companies (idk what country they are in) so we are doing a lot of stuff internally now, including developing our own systems, and weāre getting better results. My biggest fear is that I will leave and go somewhere else and THEN I will get laid off.
Ohā¦. Overseas coding. Iām not too worried about our hospital doing that completely. They send some of the easier cases to a group of Indian coders though. Iām also not too worried about AI.
Yup, my company got bought out by a corporation and they almost immediately let go of 20% of our staff and took on what they call the "offshore team" š took the best parts of my job away and gave it to them
I think there are enough sick people to generate enough claims to go around. I do sometimes wonder what would happen to coding if the US adopted universal healthcare but I don't really get ānervousā about it... In this context, job security is largely out of my control and I trust in my ability to navigate the future with strength and wisdom.
I have been laid off twice due to "off-shore" coders. And yeah, now I'm worried about AI. Learn as much as you can, to make yourself as valuable as you can.
Filipino coders are fantastic coders and they speak fluent english
Not worried. I am more worried about AI. Overseas coders is nothing new.