The Coding Manager's HandbookRose T. Dunn, RHIA, MBA, CPA, FACHE, FHFMA
Get the know-how to manage a first-class coding department
A coding manager must be an effective team leader, efficiently balancing multiple 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
