BPO Service

Medical Coding Outsourcing Services

Direct answer

Medical coding outsourcing delegates the translation of clinical documentation into ICD-10-CM, CPT, and HCPCS codes to trained coders. Actigy BPO codes to payer rules and your specialty, with maker-checker QA and audit-ready notes — improving coding accuracy and clean-claim rates, while your providers attest to the record and your compliance team keeps final sign-off.

What Actigy reports

Coding accuracyQA-sampled rate
TurnaroundCharts coded per day
DenialsCoding-related, trended
ProductivityAgainst target

What does medical coding outsourcing include?

Medical coding outsourcing covers reviewing clinical documentation and assigning the diagnosis and procedure codes that drive billing and reimbursement: ICD-10-CM, CPT, and HCPCS, plus modifiers and medical-necessity checks. Accurate coding is the difference between a clean claim and a denial.

Actigy provides coders trained on your specialty and payer mix, working inside your EHR and coding tools to your guidelines. Work runs with maker-checker QA and complete audit notes. Providers keep clinical attestation and your compliance team keeps oversight — Actigy supplies accurate, consistent, defensible coding.

Capabilities included

What does Actigy handle for Medical Coding Outsourcing?

Actigy handles the Medical Coding workflow end to end: ICD-10-CM diagnosis coding, CPT and HCPCS procedure coding, E/M coding, Specialty coding, Coding audits and QA, Charge capture support. Each task runs to your procedures with maker-checker QA and a complete audit trail, while your team keeps policy, approvals, and final decisions.

ICD-10-CM diagnosis coding

Accurate diagnosis coding to the highest appropriate specificity.

CPT & HCPCS procedure coding

Procedure and supply coding with correct modifiers.

E/M coding

Evaluation-and-management leveling to current guidelines.

Specialty coding

Coders matched to your specialty — surgery, radiology, cardiology, and more.

Coding audits & QA

Pre-bill and retrospective coding audits against payer rules.

Charge capture support

Reconciling documented services to captured charges.

Denial & rejection review

Coding-related denials reviewed, corrected, and trended.

Who is this for?

  • Providers and clinics losing revenue to coding errors and denials
  • Medical billing companies needing certified coding capacity that scales
  • Hospital and specialty groups with coding backlogs or staffing gaps
  • RCM teams that want coding accuracy measured and reported
  • Practices preparing for a payer or compliance audit

Scenarios

What situations does Actigy solve?

If any of these sound familiar, outsourcing medical coding to Actigy is worth a conversation.

Coding-related denials keep climbing.

We code to payer rules with QA and trend denial causes back into the process.

A coder left and charts are piling up.

We add trained capacity and clear the backlog without overtime burnout.

You are heading into a payer or compliance audit.

We run pre-bill coding audits and keep audit-ready notes on every chart.

Volume swings with seasonality or a new service line.

We flex coding capacity up and down without re-hiring.

Is this the right fit?

When Actigy BPO is a strong fit

  • You want measurable coding accuracy and lower coding-related denials
  • You need certified coding capacity that flexes with volume
  • You want maker-checker QA and audit-ready documentation on every chart
  • You want providers to keep clinical attestation while offloading coding
  • You are clearing a backlog or covering a staffing gap

When Actigy BPO may not be the right fit

  • You expect Actigy to attest to clinical care or practice medicine — providers keep clinical responsibility
  • You want Actigy to assume final compliance accountability or sign as your compliance officer
  • Your documentation is so incomplete that codes cannot be supported — we will flag it, not fabricate it

Why Actigy

Why outsource medical coding to Actigy BPO?

Accuracy you can measure

Maker-checker QA and a sampled accuracy score reported every month.

Audit-ready by default

Complete coding notes and rationale, so charts stand up to payer audit.

Specialty-trained coders

Coders certified on your specialty and payer mix before live charts.

Capacity that flexes

Clear backlogs and absorb volume swings without re-hiring.

Delivery method

How does Actigy launch your medical coding outsourcing team?

Every engagement follows the same pilot-first method, adapted to the controls your process requires.

  1. 01

    Process audit

    We map the current workflow, volumes, systems, exceptions, and quality bar so scope and staffing are based on evidence, not guesswork.

  2. 02

    SOP & KPI design

    We document standard operating procedures and define the KPIs and SLAs we will be measured against before anyone touches live work.

  3. 03

    Team selection

    We assemble operators and team leads matched to your domain — finance, clinical, compliance, technical — and your tooling.

  4. 04

    Training & knowledge transfer

    We run structured onboarding against your SOPs, edge cases, and systems, with sign-off before the team carries production volume.

  5. 05

    Pilot

    A controlled pilot validates quality, throughput, and turnaround against the agreed KPIs. We tune the process before scaling.

  6. 06

    Scale

    We ramp the team to full volume with capacity planning, coverage models, and the reporting cadence agreed up front.

  7. 07

    Continuous improvement

    QA sampling, root-cause reviews, and monthly business reviews keep error rates down and throughput predictable over time.

Visibility

What will you see every month?

Outsourcing coding should make quality more visible, not less. Actigy reports a sampled coding-accuracy score, turnaround, and coding-related denial trends on a fixed cadence, so the operation stays accountable across your healthcare revenue cycle.

  • A QA sample of completed work, scored against the accuracy bar agreed at go-live
  • SLA attainment — turnaround and throughput measured against your targets
  • Volume, backlog, and exception trends, so capacity stays ahead of demand
  • Root-cause notes on any error, with the SOP change made to prevent a repeat
  • A monthly business review with your point of contact and the team lead

Engagement model

How does pricing and engagement work?

Actigy prices medical coding on a transparent per-FTE model tied to role, specialty, and volume — the cost-to-quality ratio, not a cut of collections. Coding pairs naturally with medical billing under one revenue-cycle team.

Start with a pilot

A scoped, paid pilot proves quality and throughput before you commit to full volume.

Per-FTE pricing

Priced per FTE by role and your industry — not per transaction or by volume. You see the team and the cost.

You own the documentation

SOPs and process knowledge stay yours, which keeps switching costs low and cuts key-person risk.

Managed team or staff augmentation

Run it as a fully managed team or embed our operators in yours, inside your own tools.

See how Actigy would run your medical coding

Get in touch and we'll assess scope, complexity, staffing, and delivery cost — then propose a pilot to prove quality before you scale.

Get in touch

FAQ

Frequently asked questions

What is medical coding outsourcing?

Medical coding outsourcing is delegating the assignment of ICD-10-CM, CPT, and HCPCS codes from clinical documentation to trained external coders who work in your EHR and to payer rules. Actigy codes with maker-checker QA and audit-ready notes while providers keep clinical attestation.

Are the coders certified?

Actigy staffs coders trained and certified for your specialty and payer mix, and certifies them on your guidelines before they touch live charts. Work is reviewed under maker-checker QA.

Is medical coding outsourcing HIPAA-compliant?

Actigy handles PHI under HIPAA-conscious controls — scoped access, segregation of duties, audit logging, and a Business Associate Agreement signed before go-live. See our security and data-processing terms.

Will outsourced coding reduce denials?

That is the goal. Coding to payer rules with QA and feeding denial root causes back into the process typically lifts clean-claim rates and reduces coding-related denials over time.

How much does medical coding outsourcing cost?

Actigy prices coding per FTE by role, specialty, and volume — not as a percentage of collections. A Tech Lead owns quality, and you can run a managed team or staff augmentation. We quote after a short process audit.

Which systems does Actigy code in?

Actigy works inside your existing EHR and coding or encoder tools and follows your guidelines, so the service adapts to your tooling rather than forcing a migration.

Outsource the process. Keep control of the outcome.

Tell us what process you want to outsource. Actigy will assess scope, complexity, staffing model, and delivery cost.