CODING MANAGEMENT AND COMPLIANCE
Read the attached “Healthcare Compliance and Coding Management Effectiveness Scenario,” which describes several problems you might face as a newly hired health information management (HIM) department manager. This task will help you to think through the process of determining which types of coding functions are necessary for the HIM department. It will also help you in evaluating staff qualifications for hiring or downsizing purposes. The scenario also encourages you to consider the HIM workflow along with departmental quality and productivity concerns, which may influence decision making.
A. Discuss how you would systematically proceed with the challenges presented in the scenario.
1. Analyze the various job functions of the current staff.
2. Analyze the various concepts and processes behind each of the following:
a. Code look-up software
b. Encoder software
c. Charge description master table
3. Explain how you would determine job functions needed at both the hospital and the new clinic.
4. Discuss how you would structure a plan for recruiting, hiring, and retaining staff in both departments.
a. Identify others in the organization who may be helpful to your planning.
b. Describe how challenges you may encounter during this planning process could be addressed.
B. Discuss concerns related to productivity and quality standards as presented in the scenario.
1. Explain how you would identify these concerns.
2. Explain how you would address the concerns you identified.
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