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Maximizing reimbursement through concurrent coding

Case Management Weekly, May 23, 2007

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Maximizing reimbursement is one of the most important responsibilities in a case manager's job description.         

When the care management department at Saint Joseph Regional Medical Center (SJRMC) in Mishawaka, IN, was presented with this challenge, they found that one way to improve this processes was a strategy of concurrent coding. SJRMC hoped that concurrent coding would bring significant benefits, such as better documentation, more timely billing and reimbursement, and improved compliance.

To start the concurrent coding system, the staff at SJRMC began by designing an inpatient worksheet to be placed in physician's progress notes on the medical record. The idea was that the physician's progress notes would provide easy access for the physicians and other departments.

In addition, all case managers were given access to new software that helps coders evaluate and apply coding and grouping rules to individual patient records. 

To train case managers on how to use the software to help them assign codes to patients, the coding department held "lunch and learn" training sessions.

Once the care management team was trained on the new system and processes, SJRMC began to implement the concurrent coding process.

Source: Case Management Monthly, June 2007

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