About The Book
Get the know-how to manage a first-class coding department A coding manager must be an effective team leader, efficiently balancing multiple...
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responsibilities. Whether you are new to the job, or an experienced manager, this book will walk you step-by-step through your roles and responsibilities. It provides a comprehensive and detailed look at a coding manager's/supervisor's responsibilities, providing more than 50 figures, charts, sample documents, and resources to illustrate key topics and provide examples. The author provides an overview of regulatory oversight, explains the coding department's role in the revenue cycle, and provides a roadmap to successfully navigate the coding department's daily challenges. You will learn to: - Allocate resources and structure the coding function to maximize productivity - Select, develop, retain, and motivate staff - Create a documentation improvement program and query policy - Establish a coding quality review program to ensure accuracy and compliance - Implement a coding auditing program The topics covered in the book include: Chapter 1: Introduction to Management New Manager Challenges What Does a Manager Do Chapter 2: Planning and Organizing the Coding Function What Is the Coding Function? Today's Coding Function Structuring the Coding Function Resources for the Coding Function Scheduling Chapter 3: Developing, Selecting, and Retaining Coding Staff Determining Staff Size Composition of the Coding Team Developing an Apprentice Program Developing Coding Guidelines Chapter 4: Motivating the Coding Team Assessing Individual Needs Generational Differences Manager's Needs Developing Expectations Common Distractions Remote Coding Considerations Incentives as Motivators Chapter 5: Compliance and the Coding Function Implementing a Coding Auditing Program External Coding Quality Reviews Chapter 6: Coding and the Revenue Cycle Coding Connects the Cycle Coding Quality and Case Mix Index Denial Management Chapter 7: Improving Coding Quality and Reimbursement Creating a Documentation Improvement Program Key Items to Consider Including in a Query Policy Tracking Queries Chapter 8: External Forces History of Regulatory Oversight Office of Inspector General Medicare Administrative Contractors Recovery Audit Contractors Medicaid Integrity Program Hospital-Acquired Conditions Third-Party Payers Chapter 9: Daily Challenges Assign Work Queues Review the DNFB Report Payroll and Scheduling Drafting Policies and Procedures Employee Challenges Quality Audits Employee Evaluations Working with Physicians Emerging Challenges The nearly 50 figures in this book include- maps, charts, and documents such as: - Sample occurrence report - Advantages and disadvantages of individual-based and team-based incentives - Sample internal audit calendar - Letter explaining overpayment/underpayment due to coding error - Sample response to the CFO regarding decline in case mix - Sample data collecting and trending chart - Sample physician query - Sample tracking spreadsheet RAC tracking spreadsheet data components Additional resources in the online Appendix include: - Coding career ladder - Coding manager job description - Coding specialist II job description - Special report: Coder productivity benchmarks
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