2025 Gastroenterology Reimbursement and Coding Update (Virtual) | November 2024-08

08 - Leading_and_Teaching_A_Coding_Team

Pdf Summary

The webinar "Leading & Teaching A Coding Team" presented by Kristin Vaughn covers several important aspects of managing a coding team in healthcare settings. It emphasizes hiring the right fit for a practice by selecting certified coders with appropriate experience and stressing the importance of education and training, coding accuracy, productivity, and compliance.<br /><br />**Key Takeaways:**<br /><br />1. **Hiring Best Practices:** It's recommended to hire certified coders such as CPC, CGIC, or CCS. Work experience, especially in specific areas like GI coding, is valuable, and non-certified coders can be given a timeframe to become certified.<br /><br />2. **Coding Accuracy and Productivity:** Regular coding audits should be conducted to ensure high accuracy rates (90% or higher is common). These audits should be done by certified auditing professionals, and results should be used for ongoing education. Setting productivity standards is important, with specific examples given for different types of medical records.<br /><br />3. **Developing a Compliance Plan:** Assigning staff to review billing processes, conducting internal audits quarterly, and educating both coders and providers are critical components. Regular reviews help identify and correct potential errors before final claims submission. <br /><br />4. **Communication:** Essential communication between coders, billers, providers, and managers is crucial for maintaining accuracy and consistency. Policy changes should be swiftly communicated throughout the team.<br /><br />5. **Compliance Tools and Monitoring:** Frequent training, monitoring of CMS policies, and using local coverage determinations (LCDs) are recommended. Keeping track of and analyzing denials can help refine processes and avoid incorrect payments.<br /><br />The overall focus is on fostering effective team collaboration, maintaining high standards of accuracy, and ensuring continuous improvement through targeted education and proper compliance practices. This approach not only enhances the performance of the coding team but also optimizes the billing process and reduces financial risks for healthcare practices.

Keywords

coding team management

healthcare coders

certified coders

coding accuracy

productivity standards

compliance plan

coding audits

communication

compliance tools

continuous improvement