Innovative Coding Management Solution Results in Reduced Cost-Run-Rate
Medical coding is a vital function in the hospital, outpatient clinic and physician office setting. Staffers who translate physician descriptions of patient injuries or diseases into codes and enter the information into the patient’s electronic health record must have the knowledge to ensure that providers can use the coding to file for payer reimbursement and to generate patient billing.
Retaining and attracting coding talent was a challenge for Columbus Regional Health in Columbus, Ga. Like many hospitals and other healthcare providers, the health system had been working with a number of outside agencies to supplement its coding resources. While facing the federally-mandated switch to ICD-10 in October 2014, Columbus Regional Health’s need for highly-trained coding staff grew significantly. By November 2015, the provider decided that its coding strategy was not sustainable or cost effective.
Columbus Regional decided to outsource its hospital coding functions via an innovative coding management solution with Guidehouse Managed Services Inc. The initiative provided a coding solution for three of the system’s facilities: Midtown Medical Center, Northside Medical Center, and John B. Amos Cancer Center.
Columbus Regional and Guidehouse Managed Services Inc. partnered to rebadge and transition all of the coding staff at each of the facilities. The onboarding process—training and organizational development—was thorough and included a complete integration/implementation process.
Guidehouse Managed Services Inc.’s proprietary technology, CodeMETRIXSM was implemented for tracking and trending productivity and quality. Productivity standards were established, and monthly quality reviews were initiated in order to maintain a 95 percent, or greater, accuracy rate. In addition, our proprietary DNFB (discharged not final billed) management tracking and reporting tool was implemented to ensure daily trending, tracking and reporting.
Guidehouse Managed Services Inc. also agreed to mitigate the risk. As part of Columbus Regional’s risk mitigation strategy for ICD-10, Guidehouse Managed Services Inc. understood the shortage in coding resources and the financial stress of having contracts with multiple third-party resources. A key component to the partnership was Guidehouse Managed Services Inc.’s commitment to meet Columbus Regional’s needs during the transition, and go-forward, from the world of ICD-9 to ICD-10.
In the first six months of the partnership, Columbus Regional Health experienced a reduced cost-run-rate of 35%, a decreased in DNFB accounts by 67% and a reduced DNFB amount by 76%.
Partnering with the coding team at Guidehouse Managed Services Inc. enabled us to not only meet, but exceed, our initial goals during a transitional period. As issues arose, the team presented innovative solutions to mitigate risks. Throughout the project, we knew there was a commitment to our objectives that was reflected in the dedication and effort put forth each day.”
Allen Butcher, Executive Vice President/Chief Financial Officer
Guidehouse Managed Services Inc. has been the most responsive outsource company I have ever worked with. They function as part of our family.”
Edward Farr, Senior Director of Healthcare Information Management