Coding affects everything from revenue to billing to compliance. Do you have a strong solution in place?

From our experience in the home health coding market, here are five questions you should ask when evaluating your coding program.

  1. Does my coder have both clinical and coding education? While neither quality is required to perform medical coding, it is incredibly beneficial to have registered nurses with a respected industry certification providing your coding. (HCS-D, BCHH-C, or equivalent) Clinical intuition is key when reviewing the documentation and providing recommendations. Having coding certification not only means the coder has a proven depth of knowledge, but also means that they likely are staying up to date with changes to ICD-10 or the OASIS guidelines.
  2. What is my coding turnaround time? One of the clearest indicators of coding success is turnaround time. Having a coding solution that completes the reviews and recommendations in a timely manner leads to faster billing and better coordination with the clinical team in the home. Also, turnaround time can be a leading indicator for inefficiency with a coding company or burnout for an in-house coder. Industry standard turnaround time is 48-72 hours. A few companies (such as Aspen), provide even quicker service by the next business day.
  3. Am I confident my revenue is being optimized? While turnaround time is key, the quality of the coding and OASIS review is equally important for your agency. Does your coder or coding company demonstrate to you that there is no revenue left on the table? This can be done through providing regular reports, having coding quality review procedures in place or other feedback mechanisms. Many agencies hire a coder because of their certification, but have no real way to ensure their work results in optimal revenue. One possible solution is to hire a 3rd party (such as Aspen) to review your coder’s work and provide feedback on a regular basis. This can give you confidence that you aren’t leaving money on the table.
  4. Is my agency ready for OASIS-D? There are substantial changes coming to the OASIS. Many items are being removed that formerly contributed to the calculation of your revenue. With fewer items left to allow you to paint an accurate picture of the patient, it is increasingly important that you answer the remaining items correctly. Many coders don’t find time to remain an expert in the upcoming changes. This will have detrimental effects on your revenue and compliance risk if left unaddressed.
  5. Is my coder a true partner to me or just a vendor? This final question applies more to instances where you are using a 3rd party coding company. Many companies will perform your coding without providing you regular feedback on areas of concern, training opportunities and clinician-specific feedback. Your coder has arguably the most intimate view of your patients’ charts and is best positioned to help guide you in improving your clinicians’ documentation quality. Agencies that utilize coders who fail to communicate miss a valuable opportunity for improvement and feedback.

With these five questions in mind, you will be able to better evaluate your coding and OASIS review program to ensure a fast and quality process. For more information about how Aspen’s experts provide certified, next-day coding and OASIS review services, visit www.aspenhhcoding.com.