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Use these eight tips to enhance coder performance

HIM Connection, August 1, 2006

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Use these eight tips to enhance coder performance

HIM directors are always looking for ways to enhance coder productivity and improve overall departmental efficiency. Consider the following tips for achieving these often sought-after goals.

Tip #1: Establish and communicate balanced work expectations to all employees. Ensure that all employees both understand the expectations and consider those expectations fair, achievable, objective, and easily measurable.

Tip #2: Monitor each expectation and routinely share compliance goals with staff. Express these expectations in the following ways:

• Number of records coded daily/weekly
• Unbilled accounts
• Number of discharge days uncoded
• Any combination of these or others

Tip #3: If more than one coder codes the same types of records, put provisions in place to prevent "cherry picking." Cherry picking occurs when one coder chooses the easier cases and leaves behind the more difficult ones.

Tip #4: Monitor unbilled reports to ensure that cases do not age on the shelf. This can happen if a coder does not wish to tackle a particularly difficult record but keeps it in his or her assigned category. Some managers establish a rule that says there will be no uncoded record with a discharge date greater than a specified number of days. This approach encourages teamwork among coders, particularly if there is a corresponding team incentive payment.

Tip #5: Avoid placing special emphasis on coding "high-dollar" amounts. Such emphasis requires staff to find the accounts, pull them out of their routine work flow, track their whereabouts, and then, once coded, move them back to where they belong. It takes staff away from doing their other work.

Tip #6: Ensure that coders code records within the hold period. The finance department establishes the hold period or time span following discharge that the account remains available for charges and services before it drops into the claim-submission queue. Some organizations call this the "suspense" period. Once this period passes, the account is deemed "unbilled," which is when the fingers often point at HIM.

Tip #7: Avoid letting accounts fall into the unbilled category. Doing so will ensure harmony with the chief financial officer (CFO). Once you achieve this goal, approach the CFO and financial-services manager to create a daily report for cases that require interim billing. List these cases several days prior to the interim-billing date so you can assign a coding professional to visit the patient-care area to code the record in advance of the actual interim-billing date; otherwise, they may appear in the unbilled category.

Tip #8: Gain access to one of more physician advisors interested in helping the coding professionals interpret some of the unique clinical aspects of a case. These advisors can also serve as champions for coding personnel with their colleagues. For example, a physician can remind another physician with poor documentation habits about the effects on the coding staff. This interaction is a powerful agent.

Editor's Note: This article was adapted from HCPro, Inc.'s book Coder Productivity: Tapping your team's talents to improve quality and reduce accounts receivable, by Rose T. Dunn, RHIA, CPA, FACHE. For more information or to order, go to www.hcmarketplace.com, or call 877/727-1728.

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