Coding Support Models Explained: PRN, Overflow, and Outsourced

When coding demands shift, knowing your staffing options can make all the difference. This blog breaks down three common coding support models — PRN, overflow, and outsourced — highlighting when to use each, their advantages, and key considerations. Learn how planning ahead, including securing contracts in advance, can keep your workflows moving and your revenue cycle protected.

When patient volumes spike, coding staff take leave, or special projects pile up, healthcare organizations often need extra coding support. The challenge? Not every facility needs the same level or type of assistance.

Three common staffing models — PRN, overflow, and outsourced — each come with their own strengths and ideal use cases. Understanding the differences can help leaders choose the best fit for their coding department’s needs.

Quick Comparison Chart

PRN Coding Support

• What it is: PRN (pro re nata) coding support means bringing in coders “as needed” — often for short-term, specific situations.
• When it’s used:
  • Covering vacations, medical leave, or onboarding delays
  • Short bursts of unexpected volume
  • Specialty coverage for certain case types
• Advantages: Flexible, quick to scale up or down Can be targeted for specific skill sets Minimal long-term commitment
• Key Considerations: Most effective for short-term or specialty coverage rather than ongoing needs

💡 Pro Tip: To truly take advantage of PRN’s quick-turn flexibility, have a signed contract in place with a reputable company before you’re in a staffing crunch. This allows you to expedite onboarding and avoid delays when you need help most.

Overflow Coding Support

• What it is: Overflow support helps when existing staff can’t keep up with day-to-day demand, often during seasonal surges or post-system go-live periods.
• When it’s used:
  • Backlog prevention during peak census
  • Transition periods after EHR upgrades or process changes
  • Short-term help for consistent high volume
• Advantages: Keeps backlogs from forming Supports revenue cycle flow during high-demand periods Allows in-house coders to focus on complex cases
• Key Considerations: Works best when you can anticipate higher volumes and plan coverage in advance

Outsourced Coding Support

• What it is: A fully outsourced model hands some or all coding responsibilities to an external partner on a long-term basis.
• When it’s used:
  • Chronic staffing shortages
  • Need for specialized coding expertise at scale
  • Desire for predictable coverage and productivity
• Advantages: Consistent, ongoing coverage Removes recruitment and training burden from internal teams Can align with quality improvement and compliance goals
• Key Considerations: Most effective when seeking a stable, long-term coding solution

Choosing the Right Model

Selecting the right coding support model depends on:

• Duration of need — days vs. weeks vs. ongoing
• Scope — specific service lines vs. full coverage
• Goals — clearing a backlog, improving quality, or achieving stability

A PRN arrangement might be perfect for bridging a short absence. Overflow support can prevent delays when volumes spike. Outsourced coding provides long-term consistency and allows leaders to focus on other priorities.

Bottom line: Each model serves a valuable purpose. By matching the type of coding support to your organization’s specific needs, you can keep workflows moving, maintain quality, and protect your revenue cycle — no matter the challenge.

For more than 30 years, HIA has been the leading provider of compliance audits, coding support services and clinical documentation audit services for hospitals, ambulatory surgery centers, physician groups and other healthcare entities. HIA offers PRN support as well as total outsource support.

The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.