The Coding Manager's Handbook

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9781601463289: The Coding Manager's Handbook
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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

"synopsis" may belong to another edition of this title.

About the Author:

Rose T. Dunn, RHIA, MBA, CPA, FACHE, FHFMA, is chief operating officer of First Class Solutions, Inc. of St. Louis, and specializes in HIM-related services, coding support, coding audits, and operations improvement. She is a nationally recognized and respected HIM expert, and the author of Coder Productivity: Tapping Your Team's Talents to Improve Quality and Reduce Accounts Receivable, and More with Less, Second Edition: Best Practices for HIM Directors, both from HCPro.

"About this title" may belong to another edition of this title.

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