February 6, 2019

Maximizing Coding impact, Minimizing Coding impediment

Alison Hovind

Does this sound like your typical work week?

  • Mandates to again decrease your CFB.
  • Visit volumes are climbing, but you need to find a way to decrease the impact on coding.
  • Your coding productivity standards need to be formalized
  • Why is your department still having to code lab accounts?
  • Holding accounts for the same scheduling and ordering issues you have seen for the past two years; now it’s your responsibility to find a way to correct those upstream issues.

You’ve inevitably been tasked with those types of requests or questions if you oversee your organization’s Coding department.

Perhaps you’ve simply added some more coding FTEs, expanded your contract coders, or mandated overtime. Sure, those methods can help improve your metrics, but they aren’t necessarily the most sustainable, cost-effective means to address more systemic issues. The trick is to respond with data-driven analysis, combined with staff feedback (real issues that real coders struggle with daily) that most effectively addresses those issues.

At Wilshire, we have the technical and operational experts who have helped numerous customers address these issues. We take a holistic approach for this type of analysis, including: workqueue (WQ) build, inter-departmental communication workflows, edit-based workflows, configuration of simple visit coding (SVC) and much more. Accounting for each of these pieces ensures that comprehensive root cause analysis is performed to prescribe a sustainable & pragmatic approach to coding workflow impacting revenue cycle through-put.

These solutions will likely span multiple departments, specialties, and roles within your organization. They might shed light on shortcomings with third-party interfaces/integrations. Likely they will highlight issues with upstream workflows. You may even discover opportunities to integrate and fully leverage your CDI, Hospital Coding, and Professional Coding workstreams.

Another tangible benefit will include the review of your SVC “scope” – what is currently undergoing auto-coding within your system:

  • What services currently qualify for SVC?
  • Do you wonder if more accounts should qualify for SVC to gain efficiencies?
  • Do your coders complain that they code accounts they don’t need to?
  • Do too many accounts error out of SVC and have to be touched anyway?
  • Have you been live on SVC for 5+ years and need to reevaluate inclusions/exclusions?

When you couple together staff feedback & data-driven system analysis with Wilshire Group experience, you will be prepared to tackle those weekly productivity & AR/CFB demands.

Let us share our experience and help you achieve results. Contact Jen Esterbooks at The Wilshire Group today for more information!

Alison Hovind

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