Terri Eichelmann, Director of HIM at BJC HealthCare, oversaw an HIM department that was decentralized and was a mix of internal coders and contracted coders from multiple vendors. This presented challenges for both management and the coders themselves. Hear how she centralized coding and established an outsource coding partnership with a vendor that is "almost an extension of us, that we feel is part of our coding team."
Healthcare organizations of all sizes have long outsourced various functions within their revenue cycle to specialists capable of boosting efficiencies across their operation. Historically, functions thatrequire scale and technology to make them more efficient and effective have been the domain of outsource vendors (e.g., medical advocacy, transcription, and bad-debt collections). However, other areas of the revenue cycle, specifically coding, have a much lower adoption rate. Coding can benefit from scale, technology, and analytics just as much as back-office and patient access functions.
I thought you would be interested in registering for a webinar we are hosting on November 15th at 11am Central. As part of our "Learn from the Pros" series, the session is titled "Challenging the Outsource Paradigm to Improve Results" and will be hosted by Robin Smith, Director of Health Information Management and Privacy Officer at Anne Arundel Medical Center and CJ Bond, Coding Manager at himagine.
In 2015, himagine conducted its inaugural HIM Benchmark Survey in the midst of the preparation for ICD-10. At the time, approximately 56% of respondents reported that they planned to outsource at least a portion of their coding. In our 2016 survey, 63% of respondents indicated that they outsource, making it clear that most healthcare providers currently rely on some coding vendor resources and will likely continue to work with outsourced coders going forward.
The following information comes from the June 2016 issue of For the Record magazine.
As outsourcing models gain a foothold, health care organizations weigh the pros and cons.
Outsourced models are increasingly recognized as an attractive and viable option for a number of operational areas within health care organizations. In line with this trend, many organizations are considering the potential of moving either some or all of the coding function to a third-party service provider.
April 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.
An experienced medical coder brings not only enhanced productivity due to application of appropriate codes, but also knowledge of the diagnosis and procedure coding proclivities used by an organization’s healthcare professionals. They are also able to identify potential red flags and other nuances that can affect reimbursement. The benefits of working with highly trained coders are obvious as are the disadvantages of losing such coders; coder turnover disrupts productivity, which can lead to coding backlogs and increased DNFB along with higher administrative costs associated with backfilling open positions.
In a previous blog post, I discussed the ways in which the current healthcare industry outsource coding model delivers a suboptimal result for hospitals. In that piece, I highlighted some of the underlying perceptions and realities of the traditional staffing model in comparison to a managed coding solution which I believed would provide a better way for facilities to meet their outsourcing needs. In January 2015, we launched Enterprise HIM as a solution for our clients. One year later, we have completed our first Enterprise HIM Case study which showcases the value a well-designed and executed managed coding solution can deliver to providers.
In October, we launched the inaugural HIM Benchmark Report using data we gathered from over 140 HIM leadership professionals. Since that time, the findings of that report have allowed healthcare leaders to see the “big picture” in HIM by showing a broader view of management approaches and outsourcing trends across our industry.
Now that the smoke has cleared from the transition to ICD-10-CM/PCS, the healthcare industry is taking stock of how the transition changed the industry landscape.