The decision on your ICD 10 coding solution is a big one. If you have in-house coding, then you may not think about outsourcing. It may not have crossed your mind. We don't often think about coding as a part of an agency's strategic plan, but it should be. Ultimately, there are positives and negatives to in-house or outsourcing, but you need to evaluate both to make the best decision for your agency. So, let's give you some ideas on grading your agency's ICD 10 report card.
Do You Know If Your ICD 10 Coding Does You Justice?
There are so many things to worry about as agency owners and administrators. Coding if often something that is done in the background that often isn't evaluated. The reality is that most agencies do not know if their ICD 10 coding solution is a help or a hindrance. In order to adequately evaluate your program, here are some of the bullet items to consider:
1. Certification: This is not optional. Your ICD 10 coders must be Oasis and ICD 10 certified. It is necessary for compliance to coding rules and to make sure you receive proper reimbursement.
2. Competency: Our industry has a competency requirement for everything, but not coding. Regardless of whether you are outsourced or in-house, you need a check-and-balance system in place. Have a yearly random sample sent to another coding provider and have them recode the charts to see if the results are the same.
3. Job Roles: Does your coder have a dual role? Ultimately, employees who hold multiple positions migrate to the job role they like the most. You can’t afford for coding to take a back seat.
4. Cost: Have you compared the cost of having an ICD 10 coding department in-house versus the cost to have it outsourced? When it comes to cost, you need to look at the all-in cost and not just direct wage.
5. Data: If you are outsourced here, then look at what data you get from your provider. Is your provider tracking Oasis accuracy? Is there an educational component available to clinical staff to help improve Oasis accuracy? Utilize the expertise of your coding provider to make staff better.
6. Reimbursement: How do you compare to others in your state and nationally? Is your HHRG very low? Then you need to evaluate if it is an ICD 10 coding issue, documentation/ Oasis issue, or whether you are not receiving referrals that provide decent reimbursement. It may mean a pivot in your marketing strategy.
8. Turnover Time: How long does it take for your agency to get ICD 10 coding completed from your in-house or current outsourced provider?
9. Back-Up Planning: This is crucial. Most agencies, unless they have a large coding department, are not prepared for decent surge or loss of staff. So, make sure you have an outsourced company to cover you. You may have long term coding staff with lots of vacation and personal time accumulated. You have to make sure it doesn’t hurt you.
Let Us Help!
At Kenyon Homecare Consulting, we have a comprehensive ICD 10 coding solution that fits your agency’s needs. Whether you need just coding, coding and Oasis, or a back-up plan, we can help. Call us today at 206-721-5091 or contact us online. We will offer 5 free recodes today to see if your current solution is on the right track!
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