Your ICD 10 Coder Comes Into Your Office Today And Resigns Or Has To Be Out For The Next 3 Months. What's Your Back-Up Plan?

July 6, 2021
When you think about preparedness, you normally think about a pandemic or natural disaster. The reality is that loss of your ICD-10 coding solution can be huge for agencies today. Considering time constraints and the need for accuracy and compliance, you need to make sure you are covered at all times. Let's take a look at your current solutions, why you need a back-up, and how to pick the right one. 
What Are You Doing Now?
Today, you either outsource your coding, it is done in-house by a certified coder(s), or it is done in-house by an employee who is not certified and serves multiple roles within your agency. Realistically, we may often prepare for losses to other key roles within our agency, but miss this one when planning. Considering the short turnover time to complete the initial no pay RAP, agencies cannot afford to have dollars taken away because the RAP is not submitted in 5 days. So, back to the original question: What would you do?  Regardless of your coding solution, the problem applies here. Let's look at each coding solution and how to create a proper back-up plan:
  1. Outsourced Coding:   First of all, do you have a designated person or persons assigned to complete all the coding for your agency? If so, then you need to ask the company what happens if you have considerable surge or if your assigned coder quits? Basically, is the coding provider equipped to handle the loss of staff? If not, it doesn't mean you need to terminate services with a company to which you are satisfied. It means you need to put your back-up plan in place now. 
  2. In-House Coding:  This needs looked at as well whether you have certified or non-certified coders. If you only have one, then you absolutely must have a solid back-up plan in place. If you have several, the question remains to what extent can they handle the additional work until someone else is hired? Will the quality of work decline because they just need to review twice as many charts in the same timeframe? How many charts will be late? How much can you afford to lose?
What Back-Up Plan Do I Use:
This becomes your basic vetting procedure. Contact some companies that provide coding.  Let them look at a few random charts to see how they would code the information based upon what they see in your charts. Especially in the case of non-certified coders, you can often see you are missing a significant amount of reimbursement and have issues with compliance. So, put someone in place. Get your contract signed and set up someone in a back-up capacity for you. Then use the back-up during vacations and surge as well as those unexpected issues that arise. It will develop rapport and a system that makes communication easy with your agency. 
 

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