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CASE STUDY: Navigate New Code Sets with Managed Coding

Untitled_design.pngApril 1st officially marks six months since the transition to ICD-10.  While we’ve had six months to adapt to the effects of the new coding set, we only have six more before the continued expansion of the ICD code set takes effect when the partial freeze on updates implemented by CMS is lifted.  This expansion will introduce another 1,900 diagnostic codes, 3,651 inpatient procedure codes, and 487 revised code titles.  Come October 1st 2016, the HIM industry will again experience sweeping changes in medical coding making highly trained medical coders more desirable and the “great coder shortage” more daunting.  

Medical coders are crucial to their healthcare employer’s bottom line.  Quality coding ensures that claims are paid upon the first submission, resulting in faster reimbursement.  Productivity will be stalled or decline each day there is a shortage of coders. Decreased productivity can delay claim submissions and remits.  With healthcare reform driving an increased demand for medical services, it is important that providers “right-size” their team of coders in order to keep up with chart volume and productivity impacts stemming from updates to the existing coding set.

Once a provider has identified the need for additional coding staff, they are faced with two options: they can recruit and onboard coders themselves or they can work with an outsourcing vendor to provide coding resources.  Providers that take on the task themselves may quickly learn that recruiting, hiring, and onboarding coders in-house requires significant resources that could be allocated elsewhere.  If working with an outsource vendor, it is important that providers choose a partner that can accelerate the talent identification and onboarding process.

We recognize the importance of reducing the time it takes to identify and onboard coding talent which is why in 2015 we introduced our managed coding solution, Enterprise HIM, as an offering which addresses quality, productivity, and rapid implementation.  With a managed coding solution, identifying a candidate match is always top of mind and is built into the long-term contract agreement.

Over the past year, we have implemented this managed coding solution in more than 15 health systems nationwide and we published the first Enterprise HIM Case Study several weeks ago.  We previously discussed the ways in which a managed coding solution can improve quality scores and support coder retention.  Our data also indicates that a managed coding solution streamlines the hiring and onboarding process.  On average, our Enterprise HIM clients see a 38% reduction in the time it takes to identify and hire quality coders when compared with traditional staffing agreements.

There are several reasons why implementing a managed coding solution leads to a favorable recruiting and onboarding process:

  • Needs Analysis: As part of our managed coding agreement, the himagine project team completes a thorough assessment to document our client’s specific requirements.  This analysis is used to align the existing skill sets of our coders to the needs of the client.  Because we maintain a bench of available coders, we are often able to reduce or eliminate the need to recruit for a specific job order.
  • Robust Recruiting and Account Management: As the largest provider of HIM outsourcing services in the country, we are able to leverage our robust recruiting and account management organizations to continuously fill our pipeline with quality coders.  When a job order does require a candidate sourcing effort, our recruiting and account management teams are often able to begin the search the same day the client requirement is received.
  • Skills Development: Our HIM professionals are full-time employees.  We make long term investments in our employees through ongoing training, education, and development.  Our Talent Management Platform allows us to enhance our coders’ skill-sets based on client requirements.  We are able to train coders in house on different systems, in various specialties, and in more complex coding types ensuring a candidate match for our current and future clients.  

A managed coding solution accelerates the recruiting and onboarding process by building these functions into the contract agreement.  Clients benefit from our scale and experience through access to the largest body of HIM experts in the country.  By identifying and anticipating client needs, and investing in our team of coders, we are able to accommodate shifts in the healthcare industry brought on by increased volume and policy changes.

How will your facility manage the additional coding set when the partial freeze is lifted?  I am interested in hearing your feedback.  You can leave your comments below.

If you have not read the full Enterprise HIM Case Study, you can access it here:

Click to Read Our Enterprise HIM Case Study

Sources: 

Morse, Susan for Healthcare IT News: "ICD-10 to Get 5,000 New Codes"

Dustman, Renee for AAPC: Get Ready: ICD-10 Code Freeze Ends October 2016

Dietsch, Deb for PPMConnect: Billing and Coding, the Experts Point of View

Topics: ICD-10, Coding, Outsourcing