The Coding Network, LLC was established in 1995 with the concept that accurate professional and facility coding plays a mission critical role in today’s healthcare providers’ revenue cycle. Accurate coding is pivotal to improving reimbursement and is an essential component of compliance. The company’s founders and owners, Mark Babst and Neal Green, have a combined 60+ years of experience in the medical billing and coding arena. After very successful careers in academic and private medical practice management and 19 years of successfully providing billing and coding services to prestigious academic centers via their prior company, they created The Coding Network in response to the expanding demand for the expert subspecialty coding required by Federal and state compliance regulations.
Our mission has been to become the premiere medical coding company in the United States. As such, our company and our coders play an important role in the accurate reimbursement for services provided by our clients. Each member of The Coding Network’s team has a responsibility to our clients: provide accuracy in coding, superior service, and always act with the highest level of integrity. We know we operate in a world of choice and our clients’ expectations are exacting. Clients can easily accept or reject the performance of a company; they have the power to choose and to change. Consistent delivery of accurate coding in a timely manner is crucial to earning and keeping a client’s respect and business. The Coding Network has the skills and experience to help our clients meet the challenges of an increasingly complex environment. Key to turning our vision into reality is putting the client at the center of everything. By effectively aligning our exceptionally skilled coders with our clients’ clinical specialties and operational processes we offer our clients greater value, and ultimately meet and exceed their expectations.
We continue to enjoy success thanks to an exceptional team of first-rate single-specialty coders and a carefully designed strategy of focused and measured growth. We are not diverted from our vision by creating new software applications, running a consulting practice, developing health informatics, providing billing and collections services, or writing or selling electronic medical records. We’ll leave that to others and stick to what we do best, coding and auditing. We allow our clients to operate their practices without having to dedicate in-house personnel to the task of coding. Given this singular laser-like focus, we know our clients’ unique day-to-day operations and how to help them keep pace with a dynamic environment. Because of our commitment to accuracy and responsiveness, we are considered a trusted business partner by our clients.
When we first created The Coding Network, the landscape was very different. The OIG and RAC auditors were not diligently monitoring the coding of providers’ claims. Clearinghouses and their myriad claim edits were in their infancy. Electronic medical records were faint glimmers in the eyes of think-tank planners. Computer assisted coding was a fantasy. Today’s marketplace would have been unfathomable in 1995, but many important elements remain unchanged. Services still need to be coded accurately to be properly paid. The CPT and ICD systems continue to define how coding is done and services are reported. EMR’s and computer assisted coding still neither meet the OIG’s requirement for 90% accuracy nor do they guarantee the codes their systems produce.
The Coding Network has built a team of specialty specific coders with single specialty expertise that cover the entire spectrum of medical and surgical services. All of our more than 350+ coders live and work in the United States of America; absolutely none are offshore. All are credentialed and each is a specialty or subspecialty expert. They are all certified by at least one of the industry’s major credentialing organizations (AHIMA, AAPC, RCCB, or the ACMCS). Among our coding team are coders with multiple certifications, coders who are speakers at national and regional specialty conferences, coders who are coding certification trainers, coders who are or have been coding compliance officers, and coders who are authors in coding specialty publications and newsletters. Our coders are the cream of the crop.
In addition to their coding certification, we require our coder candidates to have at least three years of production coding experience in a single specialty, and five years in order to be an auditor. If they meet the certification and experience requirement, they must then pass our proprietary and very demanding specialty specific proficiency test for the specialty in which they have experience. Our proficiency tests are specialty or subspecialty focused sterilized clinical cases and are intentionally much more rigorous than basic credentialing exams. Once a coder passes our proficiency test, they must become an apprentice to the Division Director for that specialty, regardless of how well they did on the exam or their years of experience. 100% of their work is reviewed until we are totally confident that they meet our exacting standards for accuracy. Once in production mode, all coders and auditors are subject to quarterly Q/A reviews and must maintain a 90% minimum accuracy level to continue with The Coding Network.
A newly credentialed coder with little or no experience or a coder with general coding experience will find it very difficult to maintain the OIG’s 90% coding accuracy rate in some of the more challenging specialties and subspecialties (even experienced coders have difficulty just passing our specialty proficiency exams). With ICD-9 containing approximately 13,000 codes (ICD-10 will have approximately 68,000 codes) and CPT codes numbering close to 10,000, we believe it is most effective to have experienced coders who focus on only one or two specialties so that they can develop a greater understanding of the types of procedures being performed, the physiology involved, and the pertinent code sets and rules pertaining to their specific specialties. Coders must constantly educate themselves on updates to code sets and changes in coding rules so narrowing the focus to specific specialties or subspecialties allows the coder to hone their skills and become an expert. With the multitude of changes occurring in the coding arena, smart, skilled, experienced, single-specialty coding experts are even more valued today than when our company began.
This approach works. Delivering first rate targeted specialty coding coupled with unparalleled service is and shall remain our primary objective.