he medical billing outsourcing market was valued at USD 6.3 billion in 2015 and is anticipated to reach a value of USD 16.9 billion by 2024, according to a new report by Grand View Research, Inc. Large amount of medical code representation for diagnosis and treatment coupled with the presence of multiple payers renders medical billing an intricate part of any medical practice, posing significant challenges. The challenge mounts when this process mandates adherence to the International Classification of Diseases-10th revision (ICD-10) code along with dealing with rising healthcare costs and declining reimbursements. Challenges in managing in-house billing processes include setbacks experienced in the IT structure, untrained staff, billing errors, and lack of proper financial policy in place. In order to curb or alleviate these challenges, several healthcare providers, such as acute care hospitals and clinics/physician offices, prefer outsourcing their medical billing process. According to studies, in 2015, 95 percent of the independent physicians have acknowledged that outsourcing revenue management is the right decision.
Healthcare providers face certain challenges in ascertaining the disadvantages of in-house operation or benefits of outsourcing revenue management operations; hence, they arrived at this decision by implementing thorough assessment and evaluation of the revenue percentage they spend on several billing operations. Currently, the healthcare system is witnessing a subsequent increase in outsourcing of medical billing services by hospitals and physicians. This increase is attributed to factors such as obligatory implementation of complex ICD-10 coding system, increasing healthcare costs, and federal mandate to implement electronic medical records (EMR) to maintain reimbursement levels.
Further more, clinics/physician offices are gradually outsourcing their revenue management to cut unnecessary costs and prevent the burden of managing an administrative team to ensure effective handling of in-house billing functions.
Needless to say, medical billing and coding are essential in order for hospitals and other medical institutions to run effectively and efficiently. It is imperative that patient records and billing matters are handled proficiently and with the up-most integrity.
Understanding the effective need of outsourcing, Hyderabad based Medesun Healthcare offers training for medical coding and billing to more than 5000 students and provides medical coding/billing services to the US, Middle East and India. Medesun primarily focuses on Medical Coding, HL7 and HIPAA Training and also HIM-Healthcare Informatics and provides coding on Health Information System (HIS) as well.
Medesun Healthcare: The Genesis
The story of Medesun weaves passion and hard work together with entrepreneurial spirit. Dr. Guptha grew up in a very modest middle class family in Hyderabad. His father was a salesman in a cloth store. Neither his father nor his mother went to college. Understanding the power of education, his turning point came with ICD-10 Implementation wherein he was trained under AHIMA-USA. Nevertheless, there were some heart breaking situations, but Dr Guptha claims he fought them with his zeal and tasted victory.
Dr. Guptha is a World Record Trainer with 42 Certifications and 15 Years Experience in Medical Coding and Billing. Undoubtedly, he is the man who paved way for a trillion dollar Healthcare Business Outsourcing Services industry.
An AAPC and AHIMA Certified Coder that train's student in the field of medical coding/billing/HIPAA/HL7/ICD-10
The journey of Medesun dates back to 2003 when Dr. Santosh Kumar Guptha, a medical coder working for an US based healthcare company observed globalization of the US healthcare industry/ He could make out that companies were planning to outsource medical billing and coding process to India. Back in India, there was shortage of efficient manpower in the industry although scope was tremendous. Seizing this opportunity, he incepted Medesun Healthcare. The primary aim was to train the best minds in medical billing and coding and providing skilled manpower to the healthcare industry.
Medesun began their journey by training students in the field of medical coding/billing/HIPAA/HL7/ICD-10 (International Classification of Diagnosis – 10th Revision), CPT (Current Procedural Terminology) and HCPCS (Healthcare Common Procedural Coding System) for supplies and drug coding.
With meticulous training on the subject, clinical knowledge, practical application, gap analysis and communication, Medesun train students to add value to the healthcare industry. Team Medesun believes that new job opportunities for recently trained medical billing or medical coding professionals is growing much faster than the average for all other professions and leaves no stone unturned to train their students and make them industry ready. Throwing light on, Dr. Guptha speaks, “Mostly students are in a dilemma when it comes to put in money for certifications or getting placed in a good company. Opportunity wise, the industry is wide open and there’s a huge requirement of efficient medical billers/coders even till this day. We offer the value added best certification courses where student’s success drives our entire operation.” Dr. Guptha believes in order to share knowledge and to add an impact in healthcare segment; one has to perfect the art first. His recognition in the healthcare sector is immense. Most of the students who were guided by him, at present are Managers and Vice Presidents in medical coding and billing companies.
MMedesun has more than 20+ trainers who have experience working in the US healthcare industry. Their international exposure in training students definitely adds value to the healthcare segment. Other than providing medical coding/billing training to students, Medesun offers HIM training, HIPAA complex training, medical coding auditing services, and Revenue Cycle Management (RCM) services amongst others. The company also provides online medical coding training and internship programs. At Medesun there is an aura where students develop interest automatically because of their experienced trainers. Evidently, Medesun has seen an excellent revenue growth over the past few years and all their students are placed in great positions in the healthcare industry and are spread across the globe.
While in India medical coding is still in its budding stage, Dr. Guptha aspires to introduce the medical coding system in India in a full fledged way. “Medical coding has to be implemented in all hospitals, nursing homes and clinics as this helps healthcare providers in enhancing their decision making capabilities. This makes them provide affordable healthcare to all. In the next couple of months, we will be approaching the state and central government to implement medical coding in India, in a fully fledge manner. As this will save millions of rupees, avoid frauds, or any kind of abuse in healthcare,” concludes Dr. Guptha enthusiaistiacally.