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Outsourced Coding 2023
Which Firms Best Meet Client Needs in a Changing Economic Landscape?
Author
Gordon Bishop
Author
Alex McIntosh
Author
Shawn Howell
Amid the healthcare industry’s ongoing staffing shortages, many healthcare organizations are turning to external firms for outsourced coding services. These firms can provide valuable coding expertise and help control coding-related costs. This report aims to help organizations choose the right firm for their needs—detailing firms’ ability to deliver value, exceed client expectations, maintain consistent staff and high coding quality, and partner with their clients.
Oxford and Ciox Stand Out among Large Acute Care Organizations; AQuity and TruBridge Perform Best for Smaller Organizations
When choosing an outsourced coding firm, organizations may want to consider their own relative size and specific coding needs. Oxford Global Resources and Ciox Health show strong performance for larger healthcare organizations. Respondents say Oxford Global Resources has knowledgeable and empowered account representatives, a strong pool of coders, and strong partnership overall. The firm receives high marks from both facility coding and pro fee clients. Ciox Health clients highlight fast turnaround times, proactive communication about issues, and reliable, high-quality coders, especially for facility coding. AQuity Solutions performs well among smaller acute care organizations and is consistent across both facility and pro fee coding. Clients report that coders coordinate well and that the firm is flexible—for example, they offer flexible pricing through use of offshore coders. Also of note, AQuity performs best among firms with a high percentage of respondents using offshore coding. TruBridge (limited data) stands out as a strong partner for smaller healthcare organizations. Respondents say coders are knowledgeable and executives are available to meet clients’ everyday needs.
Oxford Global Resources and TruBridge (Limited Data) Consistently Exceed Expectations
Oxford Global Resources and TruBridge (the latter with limited data) both stand out for a client-centric approach and their willingness to go above and beyond and be flexible to meet client needs. Oxford Global Resources clients highlight the firm’s proactive planning, communication, and follow-up on areas like capacity, scheduling, and auditing. Clients report Oxford representatives foster strong client relationships and can solve issues that arise. Respondents describe Oxford as highly accessible and responsive to outreach. Coding resources require little oversight from the organization, and when coders leave, respondents say Oxford is excellent at finding high-quality replacements. TruBridge (limited data) clients feel the firm goes above and beyond, highlighting their speed of issue resolution, strong coding knowledge, and willingness to do extra work if needed. One respondent felt TruBridge could increase value by being more proactive and better tailoring their knowledge to the client. AGS Health, who offers a lower cost than some other firms, often relies on offshore coders. Interviewed clients frequently mention challenges with offshore coders, including language barriers and too much need for coder oversight.
Ciox Health (Limited Data) and AQuity Solutions Reduce Turnover and Negative Impacts on Clients; Frequent Turnover from AGS Health (Limited Data) Hurts Staff Quality
No firm is completely immune to the industry’s widespread staffing shortages and turnover issues, but a few firms stand out for their ability to manage turnover well. Ciox Health (limited data) has a smaller percentage of respondents experiencing coder turnover. When turnover does occur, it is usually due to Ciox proactively switching out an underperforming coder. The client experience with staff backfilling can be mixed; some say Ciox is quick to backfill resources, while others want faster replacements. Respondents using AQuity Solutions report limited coder turnover, and they highlight AQuity’s large pool of available coders. Some mention specific experiences where AQuity did a good job maintaining coverage and reducing the impact of turnover on client work. The smaller number of respondents who are frustrated by turnover feel AQuity should better anticipate their resource needs and not overcommit resources.
Turnover management is a noticeable issue for respondents of AGS Health (limited data). Respondents describe recurring turnover and coders who are still in training, resulting in mistakes that impact quality and productivity. Some report AGS coders have difficulty adjusting to changing client needs and non-standard work. Interviewed clients feel AGS could do a better job retaining coders and planning for increases in clients’ coding needs by proactively onboarding new resources.
Most Firms Provide Good Coding Quality and Quickly Resolve Misses; A Few Clients of GeBBS and Guidehouse (Both Limited Data) Very Frustrated with Quality Issues
All firms have clients who are dissatisfied with coding quality to some degree. Staffing shortages have had a negative impact overall, but coding quality remains a pain point. The firms that perform best in this market do so not only because coding quality meets clients’ expectations but also because these firms are responsive and quick to make things right when coding issues arise.
GeBBS Healthcare Solutions and Guidehouse receive the lowest overall client ratings for coding quality. While most respondents of GeBBS Healthcare Solutions (limited data) feel the coding is acceptable, several say there were challenges that led to low efficiency and missed timelines; these clients also want better lines of communication for addressing accuracy problems with the firm. Most interviewed clients of Guidehouse (limited data) report that the firm’s coding quality is good, but none are highly satisfied. The handful who are less satisfied with Guidehouse’s coders mention challenges like lack of attention to detail, problems with productivity and quality, and Guidehouse’s quality audits not matching the client’s own internal audits.
Oxford, TruBridge (Limited Data), Ciox Foster Strong Partnership; Affordability Drives Loyalty for GeBBS Clients
Nearly all interviewed Oxford Global Resources clients report they are highly satisfied with their partnership with Oxford, specifically mentioning how personable staff members are, the firm’s willingness to accommodate organizational requirements, and the way Oxford anticipates and proactively addresses client needs, making it easier for clients to effectively scale their services. Clients of TruBridge (limited data) feel their relationship with the firm is a real partnership. They say TruBridge is very easy to work with and always willing to jump on a call to help address client needs. Interviewed clients feel they are important to the firm regardless of their size (notably, TruBridge tends to serve smaller organizations). Ciox Health clients say the firm is great at communicating, listening to client needs, and helping solve problems. One mentioned highlight is Ciox’s free educational sessions that touch on topics like new codes that help clients not only ensure their coding needs are met by the firm but also become more knowledgeable in the space.
GeBBS Healthcare Solutions clients report varied experiences with the firm’s partnership. Ambulatory clients, especially those who were brought in through the 2021 Aviacode acquisition, feel communication and involvement from senior leaders at the firm are insufficient. Acute care clients are more likely to feel GeBBS executives are highly engaged as strategic partners. Despite this, all interviewed clients say they would purchase the firm’s services again—this is primarily because of their competitive price point. Clients also note transparent invoicing from GeBBS and good results for the cost.
About This Report
Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted between December 2021 and March 2023 using KLAS’ standard quantitative evaluation for healthcare services, which is composed of 9 numeric ratings questions and 3 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into five customer experience pillars—loyalty, operations, relationship, services, and value.
To supplement the customer satisfaction data gathered with the standard evaluation, KLAS also asked two supplemental questions specific to outsourced coding: these questions asked clients to rate (1) the quality of coding from their firm and (2) how well their firm manages coder turnover.
Sample Sizes
Unless otherwise noted, sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique client organizations interviewed for a given firm or service. However, it should be noted that to allow for the representation of differing perspectives within any one client organization, samples may include surveys from different individuals at the same organization. The table below shows the total number of unique organizations interviewed for each firm or service as well as the total number of individual respondents.
Some respondents choose not to answer particular questions, meaning the sample size for any given firm or service can change from question to question. When the number of unique organization responses for a particular question is less than 10, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 5, 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.
Writer
Amanda Wind
Designer
Bronson Allgood
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. © 2025 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.