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Original Question
Scenario: The scenario is that you have just been promoted to the position of Coding Manager at Memorial Hospital 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 4th Quarter 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: Memorial Hospital HIM Coders must uphold a high level of coding accuracy expectations to meet internal standards, TJC and Medicare standards, as well as 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 quality expectations for each coder are: A random sample of 20 charts demonstrate a 94% or higher accuracy rate. 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. Coders in their probationary 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. A coder not meeting the quality standard will be put on a continued education plan developed by the Coding Manager. The Coding Manager will work with the coder on a regular basis to monitor training and improvement; The next quarterly audit should show improvement up to the 94% standard; If a coder does not meet the standard in two consecutive audits, s/he 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 Deliverable: Based on this information, what other information should you collect to comply with the policy? This should be written in full sentences and should be written in such a way that I fully understand what you are trying to say.
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