How to Empower a Medical Coding Team During an Audit

How to Empower a Medical Coding Team During an Audit

There are myriad benefits to performing regular medical coding compliance audits. Frequent audits ensure that an organization is compliant with regulatory coding guidelines. In addition, audits help reduce payer denials, undercoding, overcoding, misusage of codes, and the DNFB rate. However, the word “audit” tends to stir up uneasy feelings in coders’ minds. Is there a way to dispel these feelings? The answer lies in the ability to empower the coding team.

In order to have a successful audit process¹, coders must feel like their voices are heard. We’ve compiled these strategies to help empower the coding team during the next audit:

Steps to Empower the Coding Team During An Audit

1. Establish the mentality that medical coding audits are an educational process from which coders can learn how to improve their accuracy and quality. There tends to be a negative stigma around medical coding audits. However, audits and internal/external reviews are a regular occurrence, and a necessary step in establishing a compliant company culture².
2. Promote confidence within the coding team. Show trust in their abilities and knowledge of the job by commending them for what they’ve achieved. Characteristics, such as their attention to detail and ability to communicate effectively, are essential to the success of the team and organization.
3. Use the trends analyzed during the audit as an educational resource to help the coding team improve. The areas marked for improvement within the trending and analysis data can serve as a starting point for coder education. Investing in the team with education will not only result in improved accuracy, production, reducing denials and more accurate reimbursement but empowered team
4. Create a discussion with the coders that allows them to present their reasoning and documentation behind their initial code selection. Open up a line of communication for coders to be honest about areas where they feel they need more training or support. In addition, if the audit is being conducted externally, always include the coder in the vetting process. They can offer the auditing vendor special insight into the types of cases they code and problems they encounter in their daily operations.
5. Present a realistic, achievable goal for the coding team to strive toward post-audit. As the audit comes to an end, it’s essential to set expectations in place – whether that be a new accuracy standard or denied claims rate.

Benefits of YES Coding Audits

YES HIM Consulting’s team of auditors are Subject Matter Experts (SMEs) in the field of medical coding and auditing. Backed by numerous HIM certifications, they utilize decades of industry experience to provide our clients with personalized attention and the best possible solutions.

YES strives to become a true partner to our clients throughout the auditing process. Our team maintains open communication with the client as we guide them through the audits. Then, we explain any questions they may have regarding the findings and the custom solutions plan. For more information on how to use the audit data, review our article, “Making the Data Work for You: How to Turn Medical Coding Audits into Actionable Insights.”

Our detailed audits provide trending data on an organization’s best practices, as well as errors that they often miss. Armed with this detailed audit analysis, our SMEs create a custom education plan to mentor coders toward 99% coding accuracy. Personalized education plans can include one-on-one or group mentoring sessions with experienced auditors and coding consultants. A dedicated question queue allows coders to ask raise questions or issues they encounter in their day-to-day coding procedures. See how our YES coder mentoring program can empower coders.

Helping our clients achieve peak performance, quality, and accuracy is our highest priority. Contact YES today to schedule a consultation call and to learn more about our tailored HIM solutions.

Sources:

1. MRA, 2019.
2. AuditBoard, 2021.