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Outsourced Coding 2020
Which Firms Deliver Quality and Value?

author - Mac Boyter
Mac Boyter
author - Jennifer Hickenlooper
Jennifer Hickenlooper
December 10, 2020 | Read Time: 7  minutes

The outsourced coding market has seen significant changes over the last year, including several mergers/acquisitions, sharp increases and decreases in client satisfaction, and ever-shifting coding volumes as healthcare procedures have ebbed and flowed throughout the COVID-19 pandemic. This report seeks to help healthcare organizations identify which firms are providing the quality and value needed in this environment.

Large Organizations Highly Satisfied with himagine, AGS Health Due to Responsive Support & Strong Partnership

himagine is a highly versatile and flexible firm (i.e., handles both inpatient and outpatient coding, is engaged for large and small projects, and can easily adjust the number of resources up or down depending on client needs). The firm has recently made some positive changes, particularly in the quality of the coding and himagine’s communication. Clients say the firm is listening better and seeking out additional opportunities to improve. A couple of clients mention that finding and onboarding new coders takes longer than they would like. Consistent high performer AGS Health has a relatively small customer base that includes some very large organizations. AGS Health offers both onshore and offshore resources, and the firm is described as professional, helpful, and responsive. Each client is assigned specific coders, who become highly proficient in that organization's needs. KLAS has validated both inpatient and outpatient coding engagements; a couple of clients feel AGS Health is better equipped for basic rather than specialty coding. GHR RevCycle Workforce (HCTec) also works with large organizations; the limited sample of interviewed clients view the firm as timely, proactive, and responsive.

firm snapshots

† Organizations could be using their firm for both facility and pro fee coding.

nThrive Client Satisfaction Drops Sharply amid Internal Changes

Reporting a nearly 40-point drop in satisfaction since last year, nThrive clients say that internal changes and company expansion have led to widespread issues, including a lack of leadership and strategy from the firm and a lack of partnership. Clients note that nThrive's coders often lack needed experience and knowledge, due at least partly to staff turnover, and that this leads to low coding quality and ROI. Additionally, some clients feel that nThrive misrepresented what they would be able to do. Due to these challenges, over half of nThrive’s interviewed clients say they would not use the firm again. AMN Healthcare clients have also reported a lack of executive involvement and direction from their firm, which was created in 2019 from the merger of MedPartners and Peak Health Solutions. The quality of AMN’s coders—who are onshore and are seen as more expensive than offshore options—is inconsistent; while they typically have the knowledge and expertise clients need, some have gaps in training and lack knowledge of clients’ EMR solutions. It is not unusual for clients to have to request replacements (which they say AMN is happy to provide).

overall score trend 2019 vs 2020

Strong Execution from AGS Health, himagine & UASI Leads to High Value

AGS Health and himagine (both detailed above) and UASI all execute well on their engagements, leading clients to feel they get their money’s worth from the firms. UASI’s coders are highly accurate, typically meeting—and occasionally exceeding—expectations, and clients say that the rare issue with coder quality is quickly resolved. Multiple clients describe UASI as having reasonable rates; others say the firm brainstorms new initiatives and processes with them and doesn’t charge for this partnering. Most clients feel UASI is able to adjust coverage as needed; a couple feel they are less of a priority for UASI if they aren’t doing much work with the firm. Aviacode clients report good coding quality and acknowledge that the firm is responsive when issues arise. However, this responsiveness is not always followed up with action, and clients report staff turnover and communication issues between Aviacode’s onshore managers and offshore coders. These issues combined with the perception among some clients that the firm is expensive lead to lower-than-average perceptions of value. nThrive (detailed above) struggles to deliver strong value.

value vs engagement execution

† Value scores are a composite of customer ratings for the the following standard KLAS metrics: money’s worth, avoids nickel-and-diming, drives tangible outcomes, and exceeds expectations.

AGS Health, GeBBS & Oxford Provide Strong Level of Partnership for Providing Right Resources

AGS Health (detailed above), GeBBS Healthcare Solutions, and Oxford Global Resources are all noted for their strong partnerships and executive involvement, leading to clients receiving high-quality resources that are a good fit for their needs. Clients of high overall performer GeBBS Healthcare Solutions say the firm’s coders are able to quickly onboard and have high quality right out of the gate. They also highlight the regular meetings they have with GeBBS in which the firm makes sure they are hitting their metrics and the client is satisfied. Clients also note that the firm’s responsiveness and flexibility contribute to their satisfaction. Oxford Global Resources typically wins high praise for problem resolution and their executives’ involvement with clients. Additionally, clients feel coders execute well with good quality and productivity.

strength of partnership and executive involvement

CorroHealth Maintains Quality, Productivity Following Merger

CorroHealth was formed in September 2020 from the merger of four companies, including TrustHCS. Though TrustHCS’ outsourced coding clients felt some concern about the merger, they have not encountered any challenges. Clients praise CorroHealth’s coding quality as well as their regular audits, excellent reporting, and strong partnership. A few clients describe CorroHealth as more expensive than other firms, with one attributing the higher cost to the auditing that is included with the services. Clients of Aquity Solutions (formerly the production workforce unit of MModal) also remain satisfied following their firm’s spinoff and rebranding. Multiple clients highlight the quality and productivity of the firm’s coders; others describe the coders as hit or miss (some mention that the onshore resources are better than the offshore ones). The result of four vendors merging together, Ciox Health is praised for the quality and timeliness of their coding services. Clients note that issues sometimes arise when there is turnover among Ciox’s staff due to internal promotions; however, they say Ciox resolves these issues quickly.

key coding metrics

Note: Some questions specific to the outsourced coding market were added to KLAS’ standard services evaluation after data collection for this project had begun; therefore sample sizes may be smaller than for other metrics in this report. See About This Report section for more details.

How Have Firms Supported Clients through the COVID-19 Pandemic?

Most firms have supported clients well through the pandemic. Among fully rated firms, himagine and Aquity Solutions stand out, described by clients as responsive and supportive as workloads and needs have shifted. Ciox Health clients appreciate the firm’s communication and development during the crisis; they would like to better understand Ciox’s long-term vision. Clients of GeBBS Healthcare Solutions were initially concerned about lockdowns in India, where the firm’s offshore coders are primarily located, but say the firm quickly adapted.

response to covid 19

Note: AMN Healthcare, Aviacode, CorroHealth (TrustHCS), GHR RevCycle Workforce, LexiCode, nThrive, and Oxford Global Resources not charted due to insufficient data. The question specific to COVID-19 was added to KLAS’ standard services evaluation after data collection for this project had begun; sample sizes for this question are therefore smaller than sample sizes for other metrics in this report.

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared online in real time so that other providers and IT professionals can benefit from their peers’ experiences. To enable readers to more quickly understand high-level differences in vendor performance and give better context as to how each product compares to other offerings in the market, KLAS has organized the questions from the standard evaluation into five customer experience pillars—loyalty, operations, services, relationship, and value.

customer experience pillars

To supplement the data gathered with this standard evaluation, KLAS asked four supplemental questions specific to the outsourced coding market. These questions centered around coding quality, coding productivity, coder management, and how firms have responded to the COVID-19 pandemic. These questions were added after data collection for this report had already begun and thus have a smaller number of respondents.

The data in this report was collected over the last 12 months; the number of unique responding organizations for each firm is given in the chart to the right.

about this report

Note: Some organizations may have rated more than one services firm.

What Does “Limited Data” Mean? 

Some services are used in only a small number of facilities, some firms are resistant to providing client lists, and some respondents choose not to answer particular questions. Thus a firm’s sample size may vary from question to question and may not reach KLAS’ required threshold of 6 unique respondents. When a firm’s sample size for a particular question is less than 6, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 3, no score is shown. Note that when a firm has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

Overall scores are measured on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale.

author - Elizabeth Pew
Elizabeth Pew
author - Isaac Burgi
Project Manager
Isaac Burgi
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.

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