Coding Productivity Assessment Post ICD10 Implementation May 9, 2016
Franciscan Alliance 14 acute care hospitals, 4 regions Indiana and Illinois 68 coders- 23 IP/45 OP 54.9 coder FTE’s 32 coding support/coding leadership staff Electronic Medical Record IP/OP- EPIC Scanned images – HPF (primarily OP surgery center and clinics) Billing- EPIC Clinical Documentation Improvement- 3M CDIS Prior to CAC- 3M CRS only Use CAC for Acute Inpatient (excluding mom/babes)
Corporate Coding Structure Manager/Supervisors Support staff: Auditors, Educators, Analysts Coding staff: Reimbursement Specialists, Coders HT
Pre-Productivity Study Checklist: Standardize coding workflows Regional variation was standardized whenever possible Nontraditional coding tasks were removed Discuss barriers that negatively impact productivity with coding staff Examples -orders not in standard location, system slowness HT
Pre-Productivity Study Checklist: Identify timeframe for productivity study Consider staffing and any unusual workload changes Select a time that workload is “normal” Develop productivity report Ensure it includes all data elements necessary to calculate productivity Validate it is pulling accurate data Develop nonproductive log Include only unusual items that are NOT part of the normal workflow Train staff on how to complete nonproductive logs and track coding time DM
Nonproductive Log Template
Key for Nonproductive Log Tracking
Post-Productivity Study Checklist Analyze results Identify average productivity by comparing all coders results Look for errors in tracking (higher or lower than possible) Compare results to national trends DM
How Information Was Analyzed
How Information Was Analyzed
National Productivity Trends Based on ICD-9
Post-Productivity Study Checklist: Set temporary standards Compare workload to results to see if workload can be maintained with new standards Determine timeline to begin holding staff accountable Review results with staff and set expectations Assist staff with meeting new standards Identify high performers that can demonstrate workflow for rest of staff Review barriers DM
Post-Productivity Study Checklist: Provide coders with productivity results every two weeks for the first 2 months Hold staff accountable beginning with 3rd month Establish long term goal for final standards Reassess productivity Approximately 6 months after initial study HT
Questions???? Dawn Matheson, RHIA Corporate Coding Manager- Specialty dawn.matheson@franciscanalliance.org Heather Taillon, RHIA Corporate Coding Director heather.taillon@franciscanalliance.org