Coding Compliance and Validation Case

This case is asking you to develop an ongoing review and monitoring schedule of coding quality for the next year based on the results from an outside review. You may ask yourself why I need to do this case study? The reason is that you may not be a coder or a coding manager, but you will most likely be an administrator that is very concerned about the quality of work of the coding staff and its impact on revenues in your organization. Please read the theory into practice and real world case on the attached file. Develop an ongoing review and monitoring schedule of the coding function for the next year based on the results from the outside review. Include internal and external reviews, coding inservices, physician workshops, and external seminars/educational sessions that will be performed and or provided for your staff. The schedule should be specific. In addition to preparing the schedule, outline how you will maintain coding quality statistics and report them back to the HIM Director and Compliance Committee at your facility. How will your reward your staff members who show great improvements? How will you reward and/or recognize that your staff has made improvements overall?

You are completing a plan to improve employee performance. In this case these employee’s are coders. So, you need to develop a plan identifying how you will improve the quality of coding performed by your under performing coders. What steps, education, auditing, statistics do you need to do this. Do you need to improve physician documentation so that you can improve the coding quality.

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