Harnessing Remote Resources for Internal Coder Training

June 23, 2020

HARNESSING REMOTE RESOURCES FOR INTERNAL CODER TRAINING

In the ever-changing world of health information management, the ability to train and maintain knowledgeable and highly qualified coding specialists is a necessity.  Shrinking budgets, lack of available training staff, tools, time, and focus on keeping current workloads current are just a few of the challenges impeding a facility’s ability to train current or new incoming coders.  With the emphasis on quick turn-around to keep Discharge Non-Final Billed (DNFB) and Accounts Receivable (AR)  at a minimum,  supporting coders in learning other coding specialties takes time away from sole focus on their designated patient type.

A 700- bed facility had talented internal coders who expressed the desire to progress into other patient types; however, the facility did not have the bandwidth to perform the training and education internally.  Through an existing relationship, they reached out to Excite Health Partners seeking support with expanding existing coders’ skill sets.   

The first step in the project was to define the Scope, Goals, Timelines, Challenges to the project with respective solutions, and outline Project Details.

THE SCOPE

The client needed the education to span multiple coding modalities:

  • training new coders to perform outpatient ancillary coding,
  • train current outpatient ancillary coders to be proficient in emergency department coding,
  • and to educate current emergency department coders on ambulatory surgery and observation coding. 

THE GOALS:

Numerous benefits drove the facility to support this investment in their coders:

  • well-rounded coder skills to support fellow coders;
  • cross-coverage during vacations and sick time;
  • reduced need to call in additional contract coding support;
  • improved marketing for new coders demonstrating the facility’s commitment to supporting expanding coders’ career path;
  • improved coder morale and coder loyalty;
  • improved coder confidence;
  • coders felt like they were a part of a team working together to achieve a common goal.

THE TIMELINES:

All education would be performed in specific timeframes, with the ancillary training set at 6 weeks, emergency coding requiring 8 weeks, and ambulatory surgery/observation coding spanning 12 weeks.

THE CHALLENGES:

There were three primary challenges we had to tackle:

  • Maintaining current workloads while the coders were training.
    • Excite Health Partners provided additional staffing to the client to cover productive hours lost during internal staff training.
  • Creating an educational program for the ambulatory surgery/observation trainees that would effectively cover all body systems and related procedures while moving at a pace that would meet the client’s 12-week training expectation.
    • Two body systems and related procedures were covered weekly with practice exercises to apply information covered.
  • Ensuring an effective remote training/education environment.
    • Remote training sessions were interactive and inclusive in nature, using 1:1 phone calls and group screen-sharing applications.
    • Following classroom and education time, the coders would then code “live” accounts for the duration of their training. 

THE PROJECT DETAILS

A total of eight coders were trained in ancillary and emergency department coding, four for each modality.  These two training sessions were performed simultaneously, with the 8-week emergency department training starting first for two weeks, then adding the ancillary training for the remaining 6 weeks.  Each training session began with review of basic outpatient coding guidelines and also review of the facility’s specific outpatient coding policies.  After the initial training sessions, ED trainees were expected to code a total of 40 charts per week, not exceeding 10 charts per day.  The ancillary coders submitted 50 charts a week.  On a daily basis, the educator would review the accounts for coding accuracy and make recommendations for any changes.  All audit results were sent back to the coder at the end of the day for review.  Once a week, the educator and coder had individual meetings scheduled to review the audit results and discuss any issues.  Once all meetings had occurred for the week, the educator would submit progress reports to the facility’s coding management team, reflecting the coder’s progression towards overall 95% coding accuracy.

The training program for the ambulatory surgery/observation coders was developed in a different manner.  Because a thorough understanding of anatomy and physiology is needed to code surgeries, it was important to include review of individual body systems and related surgeries prior to the coders moving to coding actual charts.  The educator met with the coders in a virtual classroom setting twice a week.  During each class time, the educator focused on one body system.  This focus included anatomy and physiology of the body system, review of common surgeries on the body system, and review of coding resources pertaining to those particular surgeries.  On completion of the class time, the coders would be given simulated system-specific operative reports to code.  Their coding were returned to the educator, who would audit the codes and respond with feedback.  Throughout the week, the coder and auditor would have calls to review and discuss the audit findings, and at the end of the week the coder’s weekly score would be provided to the facility’s management staff.  Once all body systems had been covered, then the coders were assigned 25 actual charts to code on a weekly basis, following the same auditing/feedback/scoring format.

THE CONCLUSION:

The current coding team is now more well-rounded, confident, and able to support the various incoming workload types of the facility.  The facility now has more flexibility in workload assignments with the multi-skilled coding team.  Within three months of the end of the training sessions, the facility had an external audit performed on all of their coders.  Particular attention was paid to those coders who had recently attended the education, with all having done well with passing scores.

“I was thrown into the External Audits and I passed with a 98%!! I couldn’t believe it! This has made my entire day.  I’m over the moon LOL!   Thank you so much for the training and the assistance that you gave us. This is why we have been so successful!”  — Ambulatory Surgery Coder

Excite Health Partners is here to partner with you on your education and training projects and support any level of coder development, education, and training needs.  We are ready with experienced coder educators that can train coders into separate service types and offer education to coders on specific coding topics.  All education and training projects are tailored to each individual client’s needs and goals.

 

Robyn McCoart, RHIT, Managing Auditor Excite Health Partners