Based on this information, what other past information should you collect so that you can be certain that you are complying with the policy?

Complete Part I before moving on to Parts II and III.

Scenario: Imagine that you have just been promoted to the position of Coding Manager at Rasmussen Medical Center and you are now responsible for 5 fulltime and 3 part time coders. One of the important tasks that you will need to complete on a quarterly basis is a coding audit on each of your coders and several types of reports that will summarize the audit information.

The former Coding Manager completed the recent audit but she was not able to complete any of the reports prior to her departure. She has left you with the following audit information on a piece of scratch paper:

Coder 1 88.6 %
Coder 2 96 %
Coder 3 98.9%
Coder 4 92 %
Coder 5 89.9 %
Coder 6 94.6 %
Coder 7 81%
Coder 8 91%

You don’t know the coding accuracy policy by heart yet so you set out to locate it in the policy and procedure manual and you find the following Coding Quality Policy

Based on this information, what other past information should you collect so that you can be certain that you are complying with the policy?

Please write your response in a Word document.

Do not do this assignment until you complete Part I.

Continuing with the Scenario from Part I, enter the audit summary information that was left for you (from Scenario I) into an Excel spreadsheet along with the information below that you found in the files.

CODER

QUARTER 1

QUARTER 2

QUARTER 3

1

82%

86%

94%

2

96.8%

98%

95.2%

3

92%

97%

96.9%

4

92%

94%

94%

5

87%

91%

89%

6

94.9%

95.2%

94.9%

7

NA

NA

NA

8

97.2%

94%

96%

Once you have entered the information into Excel, create a bar chart showing the 4 quarter history of audit results for each of the coders.

Do not do this assignment until you completed Parts I and II.

Continuing the Scenario from Parts I and II, you collected information from each of the coders file and prepared a table to remind you of their employment status.

CODER

LENGTH OF EMPLOYMENT

NOTES

1

1 year

2

7 years

3

4 years

4

11 years

5

1 year

2ND Probation

6

2 years

7

42 days

Address weak areas

8

2 years

Sudden drop

Now you must make some decisions based on the data that you have.

Which coders are concerns and why? List each one that you are concerned with and be specific on what part of the policy is in question.
Which coder(s) do you need to create an education plan for?
Do any coders need to be placed on probation?
Do any coders need to be considered for termination?
Are any coders in their probationary period in jeopardy of not meeting the probationary expectations?
Answer all the questions above in Memo format to your supervisor, Mary Jones, Director of HIM. Be sure to be professional, accurate, and specific about the actions that you are recommending.

 

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