Reference no: EM132633695

Assignment: Coding Audit and Reporting

Learning Objective 1. Analyze and present quality data in graphical format.
Learning Objective 2. Assess performance based on policy guidelines.

Scenario: Imagine that you have just been promoted to the position of Coding Manager at National Medical Center and you are responsible for five (5) fulltime and three(3) part-time coders. On a quarterly basis you, the Coding Manager, are required to complete a coding audit including summary reports for each coder.

Complete the following tasks:

Part I: The former Coding Manager completed the recent 4thQuarter audit but she was not able to complete any of the reports prior to her departure. She has left you with the following audit information on a piece of scratch paper:

Coder 1          88.6 %

Coder 2          96 %

Coder 3          98.9%

Coder 4          92 %

Coder 5          89.9 %

Coder 6          94.6 %

Coder 7          81%

Coder 8          91%

You do not know the coding accuracy policy, so you locate the following information in the policy and procedure manual:

Coding Quality Policy:

RMC must uphold a high level of coding accuracy expectations to meet internal standards, JCAHO and Medicare standards, and other regulatory expectations. In order to assure compliance with these standards, each coder will be audited on a quarterly basis by review of a random sample of their work. The following quality standards are expected:

1. A random sample of 20 charts will result in a 94% or higher accuracy rate.
2. Coders in their first six(6) months will remain on probation and will be expected to reach a 94% accuracy rate by the end of the probation period.
3. Coders in their probation period are expected to reach at least an 80% accuracy rate leading to the 94% standard at the end of six(6) months. A continuous improvement is expected over the duration of the probationary period.
4. A coder not meeting the quality standard will be put on a continued education plan developed by the Coding Manager.
a. The Coding Manager will work with the coder on a regular basis to monitor training and improvement;
b. The next quarterly audit should show improvement up to the 94% standard;
c. If a coder does not meet the standard in two consecutive audits, they will be put on probation for three (3) months. The next audit, after the three (3) month probation must convey the 94% standard or the coder will be subject to termination.

Part I: Begin a Word document (use the written template) and answer this question.

Based on this information, what other information should you collect to comply with the policy?

Part II:

Create an Excel spreadsheet - Enter the 4th Quarter audit summary information that the previous manager left for you intoyour spreadsheet, along with the information below that you found in previous auditfiles. You will need to construct one bar chart showing the history for each of the coders.

CODER	QUARTER 1	QUARTER 2	QUARTER 3
1	82%	86%	94%
2	96.8%	98%	95.2%
3	92%	97%	96.9%
4	92%	94%	94%
5	87%	91%	89%
6	94.9%	95.2%	94.9%
7	NA	NA	NA
8	97.2%	94%	96%

Once you have created a bar chart that shows the four (4) quarters of audit results, copy and paste it into your Word document for this assignment, labeled Part II.

Part III: You have collected information from each of the coders file and prepared a table to remind you of their employment status.

CODER	LENGTH OF EMPLOYMENT	NOTES
1	1 year
2	7 years
3	4 years
4	11 years
5	1 year	2ND Probation
6	2 years
7	42 days	Address weak areas
8	2 years	Sudden drop

Now you must make some decisions based on the data that you have.

1. Which coders are concerns and why? List each one that you are concerned with and be specificabout the part(s) of the policy in question.
2. Which coder(s) require an education plan?
3. Do any coders need to be placed on probation?
4. Do any coders need to be considered for termination?
5. Are any coders in their probationary period in jeopardy of not meeting the probationary expectations?

Attachment:- Coding Audit and Reporting.rar