Background References Methods Study Objectives Secondary Results Conclusions Primary Results We need to do better at teaching billing and coding. Today’s learners do not like tradition lecture. Background A Billing and Coding Shift in an EM Residency: A Win-Win-Win Innovation All EM residents completed the workshop All EM residents gained knowledge All EM residents liked it Effective teaching of billing and coding has been well known to be deficient in EM residencies Traditional lecture is currently used to teach billing and coding but this has limitations Howell J, Chisholm C, Clark A, Spillane L. Emergency medicine resident documentation: results of the 1999 American Board of Emergency Medicine in-training examination survey. Acad Emerg Med. 2000; 7:1135–8. Michael E Takacs, MD MS, Joshua Stilley, MD Department of Emergency Medicine, University of Iowa Teach billing and coding to EM residents by the lead coder. To improve job satisfaction of coders. One-on-one interprofessional shift Mid EM rotation EM residents surveyed Coders also surveyed All coders completed the survey All coders noted better documentation All coders noted an increase in job satisfaction This was an effective teaching workshop Residents learned Coders are more happy The Department could make more money A Win-Win-Win Innovation

Background References Methods Study Objectives Secondary Results Conclusions Primary Results We need to do better at teaching billing and coding. Today’s learners do not like tradition lecture. Study Objectives A Billing and Coding Shift in an EM Residency: A Win-Win-Win Innovation All EM residents completed the workshop All EM residents gained knowledge All EM residents liked it Our primary goal was to effectively teach billing and coding in an EM residency via an interprofessional shift in our billing and coding office. Secondary goals were to improve the efficiency and job satisfaction of our billers and coders and to increase revenue in the department. Howell J, Chisholm C, Clark A, Spillane L. Emergency medicine resident documentation: results of the 1999 American Board of Emergency Medicine in-training examination survey. Acad Emerg Med. 2000; 7:1135–8. Michael E Takacs, MD MS, Joshua Stilley, MD Department of Emergency Medicine, University of Iowa Teach billing and coding to EM residents by the lead coder. To improve job satisfaction of coders. One-on-one interprofessional shift Mid EM rotation EM residents surveyed Coders also surveyed All coders completed the survey All coders noted better documentation All coders noted an increase in job satisfaction This was an effective teaching workshop Residents learned Coders are more happy The Department could make more money A Win-Win-Win Innovation

Background References Methods Study Objectives Secondary Results Conclusions Primary Results We need to do better at teaching billing and coding. Today’s learners do not like tradition lecture. Methods A Billing and Coding Shift in an EM Residency: A Win-Win-Win Innovation All EM residents completed the workshop All EM residents gained knowledge All EM residents liked it We conducted a one-on-one interprofessional shift with our lead coder from Sept 2014 to April 2015 This shift occurred between days 11 and 18 of the 28 day rotation in EM at UIHC and composed of: a: 1 hour one-on-one interaction session on how to bill and code. 1-2 hour workshop where residents billed and coded a set of standardized charts followed by a feedback session. Resident were surveyed within 1 week after completing this shift. Coders were surveyed in April, 2015 as a measure of secondary objectives. Howell J, Chisholm C, Clark A, Spillane L. Emergency medicine resident documentation: results of the 1999 American Board of Emergency Medicine in-training examination survey. Acad Emerg Med. 2000; 7:1135–8. Michael E Takacs, MD MS, Joshua Stilley, MD Department of Emergency Medicine, University of Iowa Teach billing and coding to EM residents by the lead coder. To improve job satisfaction of coders. One-on-one interprofessional shift Mid EM rotation EM residents surveyed Coders also surveyed All coders completed the survey All coders noted better documentation All coders noted an increase in job satisfaction This was an effective teaching workshop Residents learned Coders are more happy The Department could make more money A Win-Win-Win Innovation

Background References Methods Study Objectives Secondary Results Conclusions Primary Results We need to do better at teaching billing and coding. Today’s learners do not like tradition lecture. Primary Results A Billing and Coding Shift in an EM Residency: A Win-Win-Win Innovation All EM residents completed the workshop All EM residents gained knowledge All EM residents liked it 26 of 26 (100%) EM residents completed the workshop and 19 of 26 (73%) EM residents completed the survey A paired t-test on a 5 point scale showed an improvement in billing and coding knowledge from 3.3 to 4.3, t = -6, p < On a 5 point Likert scale, EM residents Gained knowledge, Mean 4.21, SD 0.54 Found it beneficial, Mean 4.39, SD 0.50 Would change practice, Mean 4.26, SD 0.81 On a 7 point Likert scale, EM residents were satisfied with the experience, Mean 6.16, SD 0.60 On a 3 point Likert scale, EM residents felt the length of time was just right, Mean 2.16, SD 0.37 All residents were able to identify common mistakes made in their practice Residents made additional comments of being thoroughly satisfied with this workshop and recommending it be required for next year. Howell J, Chisholm C, Clark A, Spillane L. Emergency medicine resident documentation: results of the 1999 American Board of Emergency Medicine in-training examination survey. Acad Emerg Med. 2000; 7:1135–8. Michael E Takacs, MD MS, Joshua Stilley, MD Department of Emergency Medicine, University of Iowa Teach billing and coding to EM residents by the lead coder. To improve job satisfaction of coders. One-on-one interprofessional shift Mid EM rotation EM residents surveyed Coders also surveyed All coders completed the survey All coders noted better documentation All coders noted an increase in job satisfaction This was an effective teaching workshop Residents learned Coders are more happy The Department could make more money A Win-Win-Win Innovation

Background References Methods Study Objectives Secondary Results Conclusions Primary Results We need to do better at teaching billing and coding. Today’s learners do not like tradition lecture. Secondary Results A Billing and Coding Shift in an EM Residency: A Win-Win-Win Innovation All EM residents completed the workshop All EM residents gained knowledge All EM residents liked it 4 of 4 (100%) coders completed the survey, on a 5 point Likert scale, coders See consistent documentation of required elements, Mean 4.25, SD 0.50 Identify that good documentation makes their job easier, Mean 5.0, SD 0.0 See improvement in documentation from prior year, Mean 4.5, SD 0.58 Note an increase in job satisfaction, Mean 5.0, SD 0.0 Note good documentation allows them to process more charts per hour, Mean 5.0, SD 0.0 Estimate a 38% (SD 42%) increase in efficiency of charts able to process in one day. Howell J, Chisholm C, Clark A, Spillane L. Emergency medicine resident documentation: results of the 1999 American Board of Emergency Medicine in-training examination survey. Acad Emerg Med. 2000; 7:1135–8. Michael E Takacs, MD MS, Joshua Stilley, MD Department of Emergency Medicine, University of Iowa Teach billing and coding to EM residents by the lead coder. To improve job satisfaction of coders. One-on-one interprofessional shift Mid EM rotation EM residents surveyed Coders also surveyed All coders completed the survey All coders noted better documentation All coders noted an increase in job satisfaction This was an effective teaching workshop Residents learned Coders are more happy The Department could make more money A Win-Win-Win Innovation

Background References Methods Study Objectives Secondary Results Conclusions Primary Results We need to do better at teaching billing and coding. Today’s learners do not like tradition lecture. Conclusions A Billing and Coding Shift in an EM Residency: A Win-Win-Win Innovation All EM residents completed the workshop All EM residents gained knowledge All EM residents liked it A billing and coding shift is an effective teaching method for EM residents. Improvements in documentation are noticed and have led to an increase in job satisfaction and efficiency of coders. A billing and coding shift is a win for the residents, a win for the coders, and is likely a win for department revenue creating a win-win-win innovation. Howell J, Chisholm C, Clark A, Spillane L. Emergency medicine resident documentation: results of the 1999 American Board of Emergency Medicine in-training examination survey. Acad Emerg Med. 2000; 7:1135–8. Michael E Takacs, MD MS, Joshua Stilley, MD Department of Emergency Medicine, University of Iowa Teach billing and coding to EM residents by the lead coder. To improve job satisfaction of coders. One-on-one interprofessional shift Mid EM rotation EM residents surveyed Coders also surveyed All coders completed the survey All coders noted better documentation All coders noted an increase in job satisfaction This was an effective teaching workshop Residents learned Coders are more happy The Department could make more money A Win-Win-Win Innovation