PracticeMax- HBC Coding Department
RECAP
CLIENTS
STAFF
Staff has grown and to date we have 21 employees- 8 QC, 7 coder support, 6 virtual assts. in comparison to 9 QC and 3 Coder Support since Nov 2013.
VENDORS
To date we have 2 Urgent Care, 1 family practice, 1 IP Hospital, 5 ED totaling an estimated volume of 300 fdh, 17000 EPS FEP 1950 GSEP 16000, PMA 11750, UCE 25000, UTSW 12000 stat 3400 and PFP 1900 totaling 89,300
Working with Elico,, TS, IHS and GeBBS as pilot-- RSystem surgiical and GeBBS radiology and interventional radiology
ACHIEVEMENTS
STAFF
CLIENTS
Brought on two new clients during same month. Better exposure with GSEP through coder education sessions. Supported clients in various EHR transitions including GSEP and STAT. Implemented ICD10 and newsletters for education. Better reporting through MaxCode and MaxIntel.. Coding Deprt oveboard template for new clients.. as an example who we have to interface with such as DEV.. lieke client onboarding templatte and demonstrate thse achivements over time a we move forward. and assign work to other ppl to help us in those varous areas. Onething we are doing is lookign at ICD10 updates, part of that is the frace period with emdicare is going away and in AZ and OIG will be naiing ppl on plac of laterality .. do a complimentary review
Challenges
CLIENTS
STAFF
VENDORS
Hired VA which was a new concept not previously implemented in department. Brought on additional staff and began working remotely for all staff including coder support. Had training on EM coding in 2015 as refreshers Trained staff on MaxCode
VENDORS
Trained vendors on MaxCode and MaxIntel. Worked with vendors in increasing their resources due to new clients. Began transitioning clients to Elico from TS. Worked with new dept in Elico for IP services.
Coding knowledge and trend analysis is lacking throughout QC. Numerous errors made by Coder Support in day to day tasks for DocuCQC and Pending. High turnover in Coder support role over the past few years. Lack of up to date coding guidelines that is being initiated by QC staff . Higher turnover for Coders in Parkland
Unsatisfactory followup on acuity shift. Lack of definitive coding guidelines as to what we are following when rqstd by UTSW. Lost client (GULF) due to client perception of lower levels of services. Various mistakes made by HBC team for FDH and PMA/EPS exception process that caused a lot of work for client. Lost line of business for Day Surgery FDIHB and UTSW-Children without cause or explanation.
High turnover in Mgmt team thus causing alot of mistakes and oversight. Lack of definitive training material prior to new coders and staff coming on board. Negative tones during mgmt calls and disconnect in communication and expectation on deliverable.
GOALS
STAFF
VENDOR
CLIENTS
MANAGEMENT
New coding Mgr brought on in 2013. Transition Coding Mgr remotely previously not done in department. Assisted Development with implementation of MaxCode.
MANAGEMENT
Successful transition with staff, vendors and clients with ICD10. Successful implementation for MaxCode and MaxIntel and client facing. Consistent frequency of calls between Mgmt. Ability to support staff, clients and vendors during absences of Mgmt personnel. Began and completed some coding materials for Coding Dept.
MANAGEMENT
Inconsistent feedback to dept related to guidelines, coding practice. missed numerous deliverable related to improving coding dept... overextended and over promising. Lack of strategic planning when implementing various endeavors in dept such as new clients, vendor analysis and transition and training materials. Lacking in working with Compliance dept and relaying information to clients.
MANAGEMENT
Transition GSEP and FEP to Elico Finalize pilot for 2ndary vendor as backup for ED and IP business. Close the loop on training material and coding reference material. have better expectations outlined and deliverable and timely followup. Less micro management and more analysis on trending and quality. Develop easy to understand material on common med terms, ED concepts and A&P such as videos, quick reference guides so that they can understand the basics of the record. EX post nasal drip
Better communication with all clients more equally to include coding feedback, trends by client/provider, quarterly reviews and feedback and yearly face to face meeting including coding sessions. Understand the main challenges that client perceives and address more timely and consistently. Have a point person established for each client to answer questions, address issues within 48 hours and relay information from Coding Dept.
Better outline the job descriptions of each staff member and refine the roles for each staff member. Provide educational material for coders and QC to include quarterly updates and annual refreshing training. Give certain staff more resources to be able to provide better feedback to team and clients to include webinars that hey can relay to the team. Understand the resources that are available and are needed to not stretched too thinly but refrain from doing MaxCode sweeps and minimal QC on other clients.
Bring on additional resource to help support staff so that existing mgmt team can be more of a service to cleints and future endeavors. Finalize all of the coding reference material and involve Medical Directr or key personnel at clients for clinical input. COntinue to implement CPC coding material for existing and uture coders to be certified and systemize training for a higher ROI as webinars and seminars are offered by PMax. Work more efficiently with other depts to help supporthem but also gain their support for betterment of cleints, Complaince and DEV. Dedicate resoruce for IT realated tasks, physician and coder training, trend analysis for billing anomalies. Document all processes that are being done monthly or quarterly by existing Mgmt staff including nivoincing, client reporting, coding updates and guidelines