by Stacy Swartz, RHIA, CCS, CPC, Senior Director of Coding and CDI Solutions, eCatalyst Healthcare Solutions
As COVID-19 continues to strengthen its hold across the country, many healthcare organizations have faced yet another challenge: managing a remote coding work force. What can we learn from their experience thus far?
Up until COVID-19, the majority of the labor force worked on site with their colleagues and supervisors. They had easy access to share information and keep each other on track. Similar to frontline team members, leaders have found the transition from office to home difficult to manage and are feeling they are unequipped to oversee daily operations.
Below are six tips to help Health Information Management (HIM) leaders manage their remote coding operation.
1. Policy and Procedures to Govern Work-from-home – A policy and procedure is needed to establish expectations for all remote employees, including managers and coders, who will have little direct oversight. The policy should address home office requirements, on-site availability, productivity shortfalls, time and schedules, HIPAA regulations, safety, security, and confidentiality.
2. Communication – Communication is critical when managing a remote workforce. It is extremely important that work schedules, expectations and deadlines have been clearly conveyed and that employees understand the process for questions, support, and where to locate resources. File locations and/or shared drives containing policies and procedures, reference materials, daily assignments, etc. should be clearly designated and communicated.
Communication methods (e-mail, phone calls, texts, intranet, video chats) should be discussed to determine which method best fits team objectives. Although frequency of communication can vary between employees depending on the type and difficulty of the work they are performing, minimum expectations should be set.
3. Productivity – Organizational productivity expectations should be adhered to. Measure coder productivity by focusing on “final coded” or completed accounts. Determine how many charts a coder is coding on a daily, weekly, or monthly basis. It is equally as important to track claims that are held for additional documentation or clarification. Coder performance and turnaround times should be closely monitored, and workloads should be adjusted/reassigned, as necessary. It is important to remember that turnaround time requirements associated with the discharged not final billed (DNFB) do not change because you have a remote workforce. Bill hold days still apply, and leaders must manage to meet those expectations.
4. Time – Establish a work schedule that includes days and time ranges that an employee is eligible to work. Align your team’s schedule with human resource policies and procedures to address overtime and split or flex shift options. Leaders should also understand policies around shift differential to avoid unexpected, or unbudgeted expenses.
5. Quality– Organizational quality assurance requirements and corporate compliance review schedules should be adhered to. Best practice standards suggest a 3-5% monthly sample size, requiring a 95% accuracy rate.
A team that in the past would have relied on informal sharing of information to arrive at a consensus approach to coding a complex case must now count on staff reaching out to get the input of their colleagues on those thorny questions. Upcoming changes to E/M coding plus new guidance and codes for COVID-19-related cases create significant risk of audits challenging submitted codes. Post-audit education is a must!
6. Regular Team Meetings – When working remotely it is important for team members to know that their leader is available to them, even though they cannot physically walk into his/her office. Scheduling daily huddles and/ or weekly meetings is critical to keep the team engaged and provide opportunities to discuss challenges, priorities, and other operational objectives.
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About the Author: Stacy Swartz, RHIA, CCS, CPC
Stacy Swartz is Senior Director of Coding and CDI Solutions for eCatalyst Healthcare Solutions. Stacy has 25 years of experience in Health Information Management, having worked all facets of the profession from coding to billing to Vice President of Operations. With expertise in both professional and facility service lines, she has served as an educator and consultant to over 2,000 coders and upwards of 400 physicians. Ms. Swartz’s coding experience includes both inpatient and outpatient services, having worked with several of the largest Health Systems and Hospitals in the industry.