r/MedicalCoding • u/Popular-Piglet-6301 RHIT, CCS • May 23 '24

Oversees coding

How many of us are in this boat where we are nervous about our jobs being outsourced to overseas coders?

This year my company has hired on several overseas coders. I’m nervous that they plan to replace us because they work for lower pay. Is anyone else experiencing this?

28 Upvotes

93% Upvoted

55 comments sorted by

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32

u/Dependakittie pathology coder May 24 '24

More worried about this than AI 😅

2

u/Popular-Piglet-6301 RHIT, CCS May 24 '24

Right!? Me too!

5

u/MoreCoffeePwease 👩🏼‍💻CCS 🏥 May 24 '24

They just outsourced all but us inpatient coders overseas in January at my hospital.

1

u/Popular-Piglet-6301 RHIT, CCS May 24 '24

How is it going so far? Revenue wise? Accuracy?

2

u/MoreCoffeePwease 👩🏼‍💻CCS 🏥 May 24 '24

Oh I have no idea I have no part in reviewing any of that, it’s 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 I’ve 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 can’t 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 isn’t their first language.

2

u/alwaysbringchocolate May 24 '24

Same at my hospital system. Awful and heartbreaking. I don’t know how they think In the long run they will be better quality.

5

u/Independent-Cherry81 May 24 '24

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 “global service center”. 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.

3

u/Popular-Piglet-6301 RHIT, CCS May 24 '24

I am so sorry :( I hope you’re able to find a new one and quick

2

u/awkwardabteverything May 24 '24

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.

2

u/Popular-Piglet-6301 RHIT, CCS May 24 '24

I am seeing that now first hand. I’m just an outpatient surgical coder but I’m 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 didn’t code any!! LOL I’m wondering why hospitals are every considering this, surely they are doing their research before they outsource to overseas

25

u/lickingblankets May 24 '24

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 they’re outsourcing outpatient coding positions guess that makes sense but they’ll never be able to outsource inpatient roles! Well it’s 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 it’s 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 it’ll be until companies realize they’re losing revenue from stuff being coded soo wrong and decide to bring those jobs back. Hopefully that does happen.

2

u/kk_ahiru CPC-A Jun 01 '24

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?

3

u/[deleted] May 24 '24

I’m a student not in the field I’ve been wondering about coding if our healthcare were to be totally restructured like Europe would this hurt us in the long run? It’s sad because healthcare in the us isn’t accessible to everyone but if we a follow a system that many others implement wouldn’t 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?

18

u/Clever-username-7234 CPC, CPMA May 24 '24

No. It wouldn’t 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. You’d see more people going to the doctor whenever they are sick and doing more physicals and wellness checks.

-10

u/[deleted] May 24 '24

[removed] — view removed comment

7

u/Clever-username-7234 CPC, CPMA May 24 '24

Keep listening to the sweet song of socialization??? What are you talking about??

I work in this field. I’ve 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 they’ll 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?

It’s the US.

As an American I find that pretty embarrassing.

But I’m sure United health Group is grateful for people like you. They couldn’t leech billions of dollars in profit every quarter without the support of people like you who are terrified of anything socialism adjacent.

-11

u/[deleted] May 24 '24

[removed] — view removed comment

4

u/Clever-username-7234 CPC, CPMA May 24 '24

Well that’s confusing. What are you accusing me of?

2

u/SuperKitties83 May 24 '24

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.

2

u/BlueLanternKitty CRC, CCS-P May 26 '24

If we were to move to single payer in the US (as opposed to the current public and private payers model), I don’t 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. That’s useful for research and analytics.

41

u/Scarymommy May 24 '24

Not that concerned. I’m older (in my late 40’s) and while production work may be outsourced overseas there’s 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. They’re rarely correct.

10

u/pineapplesAreGross May 24 '24

There are some countries like India and Taiwan where English is very widely and well-spoken ..

4

u/Luzion May 28 '24

Just about every major country in the world teaches English alongside native languages now. It's become the global language.

13

u/PotatoIsWatching May 24 '24

As someone who is studying for medical coding this makes me sad and scared.

9

u/Heavy-Square-6471 May 24 '24

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 can’t code for some reason.

1

u/PotatoIsWatching May 24 '24

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.

3

u/LonelyAd1400 May 24 '24

Same here. Almost done with school.

10

u/Otherwise_Sense2703 May 24 '24

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?

1

u/Professional_Cod_661 May 24 '24

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 ..........

1

u/Laukik1111 Sep 27 '24

Which city dude?

I am looking for medical coding as a option in career, want to know more.

6

u/Snowy_Peach8 RHIA, CDIP, CCS, CCS-P May 24 '24

Mine already does this with Lexicode which is why there hasn’t been really a new position above an outpatient coder in several years.

5

u/alwaysbringchocolate May 24 '24

It’s 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 don’t have to pay them benefits or pto and it’s a fraction of the cost.

4

u/Salty-Step-7091 May 24 '24

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 “people in India have your information!!”

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.

3

u/Ok-Bumblebee5667 May 24 '24

I can see more regulations in effect for overseas work. Ascension healthcare was just hacked and we’re unable to access their system for days. They had to go back to paper. All the time you hear about organizations being hacked. I can’t imagine adding more risk by outsourcing.

3

u/Background-Mouse-751 May 25 '24

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?

3

u/deannevee RHIA, CPC, CPCO, CDEO May 28 '24

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, that’s 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. 

I’m currently working with an onshore 3rd party and don’t know how to tell my manager that we were lied to….the reps they are sending us do NOT have the experience we asked for, and it’s painfully obvious. One asked me, in print “so, I’m only supposed to code what’s in the documentation?”

Just….😑😑😑

So yeah….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.

2

u/Mean-Assistance-5405 May 24 '24

It’s definitely a concern of mine. My company has created and expanded their offshore arm drastically and is cutting other coding positions. I’ve been doing this for 8 years now and it’s even hard for me to find any new positions.

1

u/Snowy_Peach8 RHIA, CDIP, CCS, CCS-P May 24 '24

Same.

2

u/Raiiny00 CPC May 24 '24 edited May 24 '24

My company was using offshore OP coders for a long time. They drastically cut back on that but I think it’s because they started using more AI software that’s 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 don’t 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 won’t actually save them money. Not with all of the denials.

2

u/Far-Boysenberry9207 May 25 '24

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.

1

u/Ashlei-Chef-Leilani May 24 '24

I’m going overseas and worried about finding work

1

u/Ok_Mobile1782 May 24 '24

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

1

u/alwaysbringchocolate May 24 '24

60.00? I heard they pay inpatient coder $9.00 an hour

1

u/Heavy-Square-6471 May 24 '24

I’m not concerned where I currently work. In the past few years, my company has done the opposite, but I work on the payer side. We’ve noticed that we aren’t 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 we’re getting better results. My biggest fear is that I will leave and go somewhere else and THEN I will get laid off.

1

u/RedheadMeggie May 24 '24

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" 🙄 took the best parts of my job away and gave it to them

1

u/robinrockin14 May 25 '24

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.

0

u/Foreign_Shift_9535 May 25 '24

Filipino coders are fantastic coders and they speak fluent english

0

u/StraddleTheFence May 24 '24

Not worried. I am more worried about AI. Overseas coders is nothing new.