16 Aug This is the second assignment in the Virtual Capstone Project. The AHIM
This is the second assignment in the Virtual Capstone Project. The AHIMA Engage Community has been accessed and has provided valuable information on coding production and quality coding standards. This information supports you as you continue to follow up with the CFO on Dr. Crowe’s physician income issue. The assignment in this module will use a Decision Matrix, which is a popular tool used to assist with complex business choices.
This assignment contains four parts:
- Part 1: Gathering Data: Facility Information
- Part 2: Gathering Data: Connecting with Coding Outsource Companies
- Part 3: Decision Matrix: Locate and Enter Data
- Part 4: Prepare Your Submission
To begin this assignment, first read the scenario below and then perform the steps in the four parts that follow.
Scenario:
The Coding Unit Problem continues to develop. You realize that physician income is directly connected to coding which is part of your department. The status of the Coding Unit is as follows:
- Staffing: 25 FTEs (10 coders are assigned to Physician Office Coding)
- Assignments: Ip, Op, ER, MD Office and Professional Fee Coding
- Staff works Remote, out of office after training complete
- Over the last 4 years, the Coding Unit has had 4 different coding managers.
Alyza obtains coding production and quality standard comparison information on physician office coding from the AHIMA Engage Community. Using the standardized data and her own benchmarks, she compares the data to her current 10 physician coding staff members. Using database queries, she validates that all ten coders are meeting the production standards and then prepares a coding audit from the most recent 3 months to ensure her coders are meeting quality standards. The quality standard is set at 92% which is in line with data obtained from the Engage Community.
Quality Standards Coding Audit Results
As the Director of HIM you report the production and quality findings above to the CFO who is concerned and responds that he wants you to evaluate the possibility of outsourcing the coding work for physician office coders. The CFO went through a complete coding outsource at Rush Memorial and the financial results were very impressive. He further indicates that Fantasticode handled the coding outsource project, and their 15 years of coding experience ensured that the outsource project was successful.
You review outsource decision criteria considerations with him which include 1) financial costs of physician coding, 2) benefit impact of existing coders, 3) years of coding experience, and in addition the CFO acknowledges that any staffing outsource at LiveWell will 4) impact the facility reputation. The CFO directs you to complete research, gather all information and report back with a recommendation in 30 days. He further directs you to keep your data gathering confidential and to work directly with Human Resources for data gathering.
Part 1: Gathering Data: Facility Information
Suzanne, the HR Director, is prepared with data when you arrive to her office. She shares the following information with you:
- Full time employees get insurance benefits at a cost of $500 to LiveWell, per month, per person.
- Part time employees do not get insurance.
- Hokim, Janet, Bernie, and Carol all make $22.00 per hour and are full-time.
- Penny, Vernita, and Shemaya all make $24.00 per hour and are full-time.
- Mila, Marcy, and Tom are part-time and make $22, $24, and $25 per hour respectively.
- All full-timers work 2080 hours per year and part-timers work 1040 hours per year.
You use this information to complete Table 2 below to determine cost of the Physician Office Coding Team. However, Suzanne was unable to provide complete information for you so she left a message with Benefits Specialist, Kathy, regarding one employee benefit, Short Term Disability. Kathy, in turn, left a voicemail with her reply.
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