Rates unchanged for outsourced coders amid fierce industry competition

From Diagnosis Coding Pro for Home Health.

Coders working for outsourced coding companies probably haven’t received a salary increase in quite a while.

That’s according to DecisionHealth’s 2018 Home Health Coders’ Salary Survey, which drew 322 respondents.

Consider that the owner of one outsourced coding company, who asked that her identity not be revealed, reports that the amount she pays contracted coders performing coding and OASIS review hasn’t changed in seven years.

The rate this owner pays for coding-only charts went up from $12 to $15 when ICD-10 was implemented, but hasn’t increased since, according to the owner. She also hasn’t increased the rate she charges clients, which is generally about $55 for coding and OASIS review, and $20 for coding only.

The reason for the stagnant rates stems from the fact that many of her clients are making do with smaller budgets themselves because of regulatory changes and decreased reimbursement and just won’t pay more, the owner says.

Additionally, she’s competing with outsourcing companies who are charging clients less — “in the $40s,” she says — per chart.

Another outsourcing company owner, who also didn’t want to be named, confirms that competition among outsourcers is “really stiff” and is based on price. This owner also hasn’t changed the per-chart rates she pays coders in “a long time.”

This owner pays coders about $40 per for coding and OASIS review and $20 to $23 per chart for coding only. Some coders may start at lower rates and then climb up once they prove their accuracy. Clients are charged between $55 and $75 a chart, she says.

In an attempt to be fair, this owner also will vary the rates paid based on the difficulty level of the software programs that different clients use, which can significantly impact a coder’s productivity and therefore the amount that can be made in a standard workday, the owner says.

Coding a chart in a more user-friendly program may be paid a lower per-chart rate than a chart that must be coded in a more tedious program, she says.

Other outsourcing companies pay less per chart. A coder based in Michigan, who asked to remain anonymous, performs work for two places. She codes remotely for an outsourcer that pays $10 a chart for coding only and she also contracts with an agency to do its coding for $35 per chart.

She’s hoping to eventually earn enough from both jobs to match the $35 per hour wage she used to make in a past job at an agency but is not there yet. This coder is a licensed practical nurse with a bachelor of science degree in health administration and is HCS-D certified.

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