The following article is drawn from our recent roundtable discussion on the Impact of COVID-19 on the Coding Function. To view the complete roundtable discussion, see The Impact of COVID-19 on the Coding Function: A Roundtable Discussion.
MODERATOR: Skilled coders are a valuable resource. As a manager, how do you keep remote coders engaged and connected to enhance employee retention?
“How do I respond to an employee’s request, concern, or need? How do we communicate when they need time off or when they are frustrated with a work-related issue or just want to talk to me? Do they know that I care based on my decisions, communication, and actions? I have read that people don’t leave an organization—they leave managers.”
AUGUSTE: Things are so different now. I used to see staff in the office, but now everything is virtual. I meet with staff weekly to give updates, and it seems to be working well so far. Managing a completely remote department is new territory for me, and I’m constantly seeking new and innovative ways to keep people engaged.
TAKEI: Communication—email, online educational meetings, training, seminars, and phone calls.
HARMON: As a leader, I think that the decisions I make every day relate to this issue. How do I respond to an employee’s request, concern, or need? How do we communicate when they need time off or when they are frustrated with a work-related issue or just want to talk to me? Do they know that I care based on my decisions, communication, and actions? I have read that people don’t leave an organization—they leave managers. I work hard to be the kind of manager who supports and cares for my team members. Not everyone is happy 100% of the time—and sometimes folks choose to leave—but I feel that I have learned a lot about how I need to show up for my team and not take anyone for granted.
PELLETIER: We have had multiple meetings via Zoom and GoToMeeting using video. Communication between staff and leadership is also important in terms of keeping employees engaged and helping them understand regulatory changes that affect their workflow. Our ER coders also have morning huddles to talk about workload and other challenges. In addition, our coders receive a monthly scorecard that includes their production, quality reviews for 10-30 charts, and level of engagement. If they don’t meet certain parameters, they must meet with their manager to discuss barriers and goals. Managers play a key role in making sure staff have everything they need while working from home.
OSBORNE: We have had a 100% remote production coding workforce for about 7-8 years, so COVID has not been a shock. During that time we have worked very hard on increasing the number of one-on-one and service-line oriented staff meetings so that coders stayed engaged. In fact, COVID has even advanced us to the next stage with use of Zoom and Teams for video interactions that we never had before now that our managers are remote as well.
This year, we just finished our first annual virtual coding retreat during which doctors and other clinicians provided clinical education to our coders. It was originally set to be in-person, but due to COVID, we moved it virtually with great success. Our employee education group also provided education on the topic of ‘belonging.’ In addition, we had a medical terminology spelling bee. In January, we’re going to do a mini-retreat—a one-day event with presentations by clinicians.
MODERATOR: What is the most important lesson you’ve learned since the pandemic began?
“I think with COVID and the stress we’ve all experienced, I communicate differently now. I’ve become more aware of trying to connect. It’s not just about the task – it’s about the people, too.”
AUGUSTE: Flexibility. We don’t know if and when this will end or whether we’ll see another surge.
TAKEI: Coders are eager to obtain and master new medical information necessary to be proficient in their roles. They are flexible, adept, and capable of adjusting to new coding guidelines at a moment’s notice.
HARMON: Never say never. We don’t know what tomorrow is going to bring. We need to be agile and able to pivot and step up to new challenges.
PELLETIER: Coders need to be involved as workflow processes change. For example, front-end staff may not realize that the appointment type they choose directly impacts the CPT codes and modifiers that drop onto the claim. When a physician changes a video visit to a phone call, front staff weren’t necessarily changing the appointment type, which meant that the wrong CPT code and modifier were assigned. Bringing coders into these conversations was paramount.
RUSHBROOKE: I think with COVID and the stress we’ve all experienced, I communicate differently now. I’ve become more aware of trying to connect. It’s not just about the task – it’s about the people, too.
OSBORNE: When you’re in a place where you need to make a decision one way or the other, you need to trust yourself. We also need to understand that the data we’re collecting is key to our local, state, and federal governments to see the short and long-term impacts of the pandemic. Managers feel that responsibility a lot. We felt it pre COVID but now we really feel it.
Barbara Auguste, CPC, CPMA, Director of Professional Fee and Outpatient Coding Services at Maimonides Medical Center in Brooklyn, New York
Rebecca Harmon, MPM, RHIA, CCA, HIM Director and Educator in Pennsylvania
Maryellen Osborne, RHIA, Enterprise Director of RCO Coding and CDI at Mass General Brigham in Boston, Massachusetts
Wendy Pelletier, RHIA, CCS, CPC, Director of Coding at Maine Medical Center in Portland, Maine
Christopher Rushbrooke, MHA, RHIT, CCS, Associate Director of Coding and CDI at Mass General Brigham in Boston, Massachusetts
Cheryl Takei, MHA, RHIA, CDIP, CCS, HIM professional in southern California
Lisa A. Eramo, MA, moderator and freelance writer
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