A regional healthcare provider outsources their coding processes to improve quality and cut costs using a Health Information Management solution.
SITUATION
A healthcare client was seeking a partner to outsource the entire coding process including tighter management to increase productivity and reduce the Discharged Not Final Billed (DNFB), which was near $30 million. Other goals of the engagement included increasing the overall coding quality; improving outcomes management; raising the level of education about coding and clinical documentation throughout the organization; performing regular coding audits to improve coding quality and productivity; and performing knowledge transfer and transitioning back to in-house services.
SOLUTION
To address the scope, we partnered with the client to further understand the goals and objectives of the program and determine the best resource plan to achieve them. We implemented the methodology and standards of our Health Information Management Coding and Auditing solution to deliver a program that focused on productivity, coding quality and coder education opportunities. Our project team consisted of the following:
- Engagement Manager and Engagement Coordinator
- Coding Manager
- 4 full-time Inpatient Coders
- 3 part-time Inpatient Coders to address surge needs
- 9 Outpatient Coders
- Auditor/Educator
Additionally, our team built a weekly communication schedule with the client to report progress, coding results, productivity, and quality to actively measure results against program goals and drive continuous improvement.
Coding accuracy improved by 15%
RESULT
Our client achieved the following within seven months:
- Reduced DNFB by more than half
- Increased billing production by increasing average dollars billed by 30% per hour of coding
- Increased coding accuracy to 95% (up from 80% from in-house coders)
- Raised the level of clinical documentation quality
- Maintained communication for knowledge transfer
