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Introducing 7 Rewards Of A Killer Coding And Documentation Plan

If your home health organization were a baseball team, who would it look like? Would it resemble the deadly bats of the Yankees’ “Murderer’s Row” or of Houston’s “Killer Bs,” or unfortunately, would it be akin to Mudville’s “Casey at the bat?”

To succeed in sports, you need a winning strategy and a well trained, disciplined team working together toward a common goal. The same principles translate into the home health and hospice world. Therefore, it takes a “killer” coding and documentation plan to maximize your reimbursements.

Benefits of an “Killer” Coding and Documentation Plan

Successful claims submissions are the lifeblood of your agency’s revenue stream. Only by successfully mastering a coding and documentation plan can you be sure your revenue stream is full and fast-moving.

It takes prolonged effort and careful thought to form a superior plan. Also, discipline to constantly adhere to this plan requires practice. And hiring dedicated staff and keeping them well trained staff is essential. But, the reward of a healthy bottom line is well worth your investment!coding and documentation

Methods Ensuring Your Coding and Documentation Plan Reaps Rewards

Here are seven specific ways your killer coding and documentation plan will reap higher reimbursements:

  1. Consistently correct and sufficiently specific coding. Only by hiring/training skilled coders can you expect to consistently match diagnoses to the correct ICD-10 code. And only by training clinicians to document with an eye toward ICD-10 requirements will coders be put in the position to “work their magic.”
  2. Rely on certified home health and hospice coders. Certified coders know how to maximize reimbursements. They realize the importance of OASIS documentation and home health-specific billing requirements. They are familiar with the complex CMS rules navigated in order to max-out every claim.
  3. Documentation is in sync with other providers. Not only must documentation be accurate but it must also be consistent with doctors, hospitals, and other healthcare services involved in caring for a client.
  4. Unfailingly high OASIS integrity scores. Over time, CMS is getting stricter about meeting compliance criteria. Standards for OASIS integrity scores rose from 70% to 80% in July 2016, and eventually will raise yet again. Unless you make this mark, penalties will reduce your compensation.
  5. Regularly submit claims timely. Reimbursement delays are a result of improper submissions leading to revisions and subsequent re-submissions. Unfortunately, low productivity is also a direct result of costly re-submissions. Without specific protocols and adequate training, staff lacks the ability and confidence to document and code quickly without making errors.
  6. Stay 100% up to date on coding changes. By staying up to date, you avoid unnecessary claim delays and denials. CMS offers coding and documentation tools and update emails to notify you of changes. Going forward expect annual and triennial ICD-10 updates. A new expanded list of manifestation codes announced in mid-August requiring implementation on October 1, 2016, contain dozens of new diabetes mellitus codes. Most likely, agencies unaware or not implementing these updates will receive a returned to provider (RTP) notice delaying reimbursement.
  7. Allow managers the time to manage. When certified coders or an outsourcing partner is in place, managers are able to focus on their primary responsibilities. Consequently, your  managers will then have time to monitor documentation and coding, educate, and mentor staff. And when managers are freed up to really manage, the whole organization benefits.

Benefits of an Outsourcing Coding and Documentation Partner

Another popular approach to a stellar coding and documentation plan is to engage an outsourcing partner. This provider will handle all coding tasks and assists mangers ensuring clinical documentation is complete.

While some suppose that in-house coding saves money, this is often not the case. Typically, outsourcing generates more revenue by boosting reimbursement rates. Outsourcing also eliminates the danger of cash flow back when in-house coder(s) get sick, go on vacation, or quit. In addition, your coding partner will keep you up to date on coding and documentation changes. Embrace the benefit of experienced certified coders, freeing your staff to focus on client care.

Kenyon HomeCare Consulting offers full coding outsourcing and on-site or web-based education to improve your clinical documentation. Kenyon’s Coding Plus program offers help to improve every aspect of your coding and documentation plan. Discover how Kenyon clients increased their case-mix and reimbursement rates by 29% to 48%

To learn more about Coding Plus call us at 206-721-5091 or visit us online to schedule a time to talk at your convenience.

Category: ICD Coding

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