For the past three years, Clinique de la Source has outsourced its entire medical coding to Swisscoding. Through this collaboration, the clinic benefits from Medizincontrolling and retrospective file review services, leading to optimised billing, improved profitability, and more structured communication between medical and administrative teams. Cédric Zuchuat, Administrative and Financial Director, reflects on the partnership and its impact.
Why did you decide to outsource your medical coding? What challenges were you facing beforehand?
We were vulnerable due to a lack of qualified staff in medical coding. The workload kept increasing, especially with documentation retrieval, DRG adjustments, and communication with insurers. When one of our coders left, we made the decision to outsource the function entirely. I’ve never looked back, coding quality has significantly improved.
Beyond coding itself, what services do you receive from Swisscoding?
Swisscoding handles the full process: coding, follow-ups, and communication with insurance providers. They also audit our files and highlight areas for improvement. With their support, we introduced comorbidity checklists to raise physicians’ awareness of the impact certain diagnoses have on coding. One of Swisscoding’s medical controllers has visited our clinic several times to train our medical teams on these topics.
Why is raising awareness among doctors so important?
Many comorbidities affect billing but are not systematically documented. In orthopaedics, for example, a respiratory condition may not be mentioned in the record of a patient receiving a knee implant, even though it could influence reimbursement. Creating these links between clinical and financial aspects is essential, and that’s precisely what the Medizincontroller helps facilitate.
Have you been able to identify services that were previously unaccounted for?
Yes, we discovered that we could code services like diabetology and dietetics, which hadn’t previously been billed. With Swisscoding’s help, we introduced structured service forms so that nurses and care teams can document their interventions directly at the patient’s bedside.
Have you recovered revenue through these optimisations?
Absolutely. Swisscoding re-coded files from 2022 and 2023, allowing us to recover several thousand francs from insurers. Their analytical insights provide real added value—especially by identifying fluctuations in our Case Mix Index (CMI). For instance, in October, we noticed that a drop in our CMI was due to a decrease in intensive care hours compared to the previous year. These insights help us respond proactively and better understand financial variations.
Did you have concerns about outsourcing your coding?
Initially, we feared losing autonomy. But in reality, we gained visibility and greater control over the status of our coding and its optimisation.
How does this increased accuracy in coding influence your financial management?
It doesn’t allow us to forecast revenue precisely, since we still depend on physicians’ activity, insurance agreements, and the structure of the DRG catalogue. But it does give us a real-time, transparent overview, which helps us respond more effectively to fluctuations.
“Initially, we feared losing autonomy. But in reality, we gained visibility and greater control over the status of our coding and its optimisation.”
Cédric Zuchuat, Administrative and Financial Director at Clinique de la Source in Lausanne.
Beyond profitability, how does this work contribute to the quality of care?
By optimising revenue, we’re able to continue investing in state-of-the-art equipment and attract top physicians. We can also maintain a high staffing ratio for nurses, which is essential, our added value lies in the time nurses can dedicate to each patient. Sound financial management is what enables us to deliver optimal quality of care.
Bridging the gap between finance and medicine is a challenge. How are you addressing it?
Starting in 2025, physicians will be directly impacted by the CMI, which will naturally lead them to collaborate more closely with the finance teams to improve documentation and coding quality. In this context, the role of the Medizincontroller will become even more strategic. We’ve also hired an Itinerary Patient Manager (IPM), whose role is to bridge communication across teams and ensure that all critical information is properly documented.
What are the key challenges you foresee?
We need to find a new balance with both insurers and physicians, particularly as pricing models and fee structures evolve. The future of supplementary insurance is also a concern, the current LCA model no longer incentivises patients to purchase additional coverage, which may create sustainability issues for private care financing. We must work with insurers to develop viable solutions. Lastly, with the upcoming reforms to TARMED and the shift toward bundled payments, the complexity of coding will only increase.
Is having a partner like Swisscoding a real advantage in this environment?
Definitely. Their expertise helps us navigate growing complexity, especially with the challenges of outpatient coding on the horizon. In a constantly evolving healthcare landscape, having a strategic partner like Swisscoding is a true asset.
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