On-Demand Coding: Don't Sacrifice
The healthcare industry is maturing to meet the demands of the country’s aging population. As Americans grow older, they consume more healthcare services. Not surprisingly, the U.S. Bureau of Labor Statistics reports medical coding is expected to grow by 15 percent in the coming years.
This growth may pose a concern to hospitals and physician practices when it comes to deciding if they are staffing enough coders to meet the demand. This trend is reminiscent of the staffing escalation in preparation for ICD-10 implementation.
It took a year or two for coders to become proficient in ICD-10, and as a result, some healthcare facility’s in-house coders can now handle the workload without additional vendor support. Many, however, still find they need coding support of one kind or another. Rather than ongoing support, there are facilities that have found supplemental assistance solutions for when staff coders may be out for an extended period (i.e., jury duty, maternity leave, illness, extended vacation), or just to help meet deadlines and decrease DNFB.
As a complete revenue cycle company, Healthcare Resource Group (HRG), understands the significant impact temporary staff shortages have on the bottom line. As most CFOs and HIM Directors know, the loss of productivity of just one coder can negatively impact the unbilled or DNFB, which ultimately delays revenue for the organization. HRG knows it doesn’t take long for a small backlog to become seemingly insurmountable. In these cases, a vendor that offers a flexible solution and provides coders as needed is an ideal solution to help augment the coding team.
Utilizing coding on-demand is a smarter option than pushing in-house coders to unrealistic production and ultimately sacrificing coding quality. As a prior Associate Compliance Officer, I have seen time and time again how unrealistic productivity expectations end up increasing healthcare organizations’ risk and costing them revenue due to inaccurate coding. Efforts to reduce backlog inevitably present challenges in balancing productivity without compromising quality. High DNFB is less than optimal, but creating a more significant problem with inaccurate and non-compliant coding, puts your organization at risk for payer audits, potential paybacks, and fines. We all know that the RACs are in full force and eager to find errors.
Utilizing coding on-demand services might be right for your circumstances, however, due diligence is strongly recommended before selecting a vendor. Ensure the vendor you select desires a true partnership, provides a solid leadership team to support you and the coder, mirrors your processes, and most importantly, has a robust auditing program to guarantee coder quality. Just because it is a short-term engagement doesn’t mean you need to sacrifice the same level of quality and excellence you would receive with a long-term engagement. You should still expect the best!
About the Author
VICE PRESIDENT OF CODING SERVICES
Carole is in charge of HRG’s coding services group, providing remote coding services to hospitals, clinics and physician practices across the country. Quality is Carole’s singular focus to provide compliant and accurate coding services to all HRG clients.
Carole is certified in Healthcare Compliance (CHC) through Healthcare Compliance Association (HCCA) and is a Certified Coding Professional (CCS-P) through American Health Information Management Association (AHIMA). She is a member of several professional associations including HFMA, AHIMA, WSHIMA, AAPC and HCCA.