Coding backlogs can build slowly, or happen suddenly. The expectation in most facilities is that charts should be coded within 3 to 5 days of discharge, and Accounts Receivable needs to be below a predetermined dollar amount. In this facility, the backlog started off slowly, and when it grew to several hundred charts, far outside of the 3 to 5 days of discharge, they knew they needed help. Facing bankruptcy, this facility chose to hire a coding service versus hiring additional coders. They needed help with their backlog quickly, therefore, recruiting new staff was not an option in the time frame that they required.
We sent in a team of on-site coders to attack the backlog, while working simultaneously with the Information Technology department to set up remote access for the off-site coders. We were able to put together a team of experienced, credentialed coders, who then brought the backlog under control in the first week, and eliminated the entire backlog in less than a month.
We addressed the Inpatient charts first in order to generate the most revenue quickly. Once that was down to a manageable size, we went to work on the Outpatient charts. One of the challenges that we faced was determining what charts were able to be coded and what charts were missing necessary information. We were in a unique position since we also provided the Medical Transcription for this facility and were able to research each chart to determine if the Operative Report had been dictated.
The research was based on the Daily Discharge Reports, which yielded a mix of results. Many were not coded simply as a result of the backlog. However, other charts were not coded for a variety of reasons including mismatched Dates of Service, missing or incorrect Account Numbers, or perhaps incomplete or conflicting documentation.
Because of the conflicts in information, the Operative Reports did not export into the record in the EMR, which resulted in uncoded cases. We were able to report the results to the department and in the majority of cases, the issues were resolved and the charts were coded. One issue that we uncovered was that critical information was not being dictated for Wound Care reports, which accounted for a significant number of the uncoded charts. With that information, the department was able to educate the dictators on the required information and the problem was eliminated going forward.
By utilizing a coding service, the facility was able to eliminate the coding backlog quickly, which played a pivotal role in accelerating their cash flow by maximizing reimbursement under dire circumstances. We continue to provide both Coding and Transcription services to the facility.