Health Information Management

Evaluate CAC and software expenses

HIM-HIPAA Insider, October 25, 2011

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Gloryanne Bryant, RHIA, CCS, CCDS, regional managing director of HIM (Northern California Revenue Cycle) at Kaiser Foundation Health Plan Inc. & Hospitals, in Oakland strongly supports investigating computer-assisted coding (CAC) and its potential positive impact on productivity and quality. CAC uses technology to "read" charts to identify diagnoses and/or ­procedures that have the potential to be coded. "That saves us the detailed job of reading every word in the ­medical ­record," Bryant says. "Not only does it help identify ­potential diagnoses that we would want to capture, but CAC also provides you with particular potential code(s) that are ready for validation."

This shortens the time coders need to code a record, which can help you reduce overtime costs and days in accounts receivable. CAC can also yield ­higher quality and accuracy because the system reads ­every character. People may accidentally skip over  pertinent information or be interrupted and inadvertently miss capturing a diagnosis. For example, CAC coding for  ancillary services (e.g., radiology, CT scans, or MRI) can achieve 97% accuracy through automation, Bryant says. But ­Bryant cautions that CAC is not intended to replace coders, particularly in the inpatient arena. "You still have to have a validation process," she says.
 
In addition, review your coding software ­expenses and consider whether it's time to renegotiate your contract or look at ­other vendors. Because of all the scrutiny by RACs and other auditors around compliance, coders need an encoder or some type of coding software that includes online reference tools (e.g., access to ­AHA’s Coding Clinic or CPT® Assistant) instead of having to purchase these tools separately. Assess your current fee structure with your software vendor and evaluate what it's bringing to the table, Bryant says. "Are they meeting your needs, and could someone else do it at a lesser cost?"
 
Assess the functionality of the coding software and take a periodic litmus test of industry developments. "There's always good competition, and things are always advancing so quickly in the technology world," Bryant says. "It's good to step back and determine whether it's time for a change."
 
Editor’s note: For more advice, access the article in its entirety in the October issue of Medical Records Briefing.



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