Looking to 2021 - The Role of the Coder In the World of The … · 2020. 10. 12. · 1 Looking to...

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Looking to 2021: The Role of the Coder in the World of the Pandemic

Marsha S. Diamond, CPC, CCS, COC, CPMA, AAPC Fellow

10/24/20 Coding Fiesta

Where We Are…..

• It is estimated that somewhere between an additional 30% to as much as 45% of the

coders in the healthcare field were thrust into a remote coding environment

somewhere during the inception of the COVID pandemic. In many instances, the need

to convert these employees to remote was immediate, and many practices and

facilities made little or no changes to management strategies that are imperative to

the continued success of the organization.

• As we work our way through the eye of the Pandemic, and begin to accept (although

not willingly) the changes that have evolved in the world around us, it is time to take a

look back at how our organizations entered the remote coding arena and what

changes/updates need to be made in processes, policies, procedures and other areas

of our organization both during the continued pandemic as well as in the future, when,

someday, this will all be behind us.


Coding Fiesta 2020 Marsha S. Diamond, CPC, CCS, COC, CPMA, AAPC Fellow October 24, 2020

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TAKE ACTION! EMPLOYEES & EMPLOYEES

• Don’t wait for your employer to take action

• Make suggestions to Managers and Management that could improve your remote experience

• While 60% of remote employees prefer working remotely, employee sustainability has suffered

• 41% of remote workers to not feel connected to colleagues and the organization

• 26% of remote workers feel isolated

• Offer to be part of the solution, not the problem – be willing to work with management on a task force or other committee to improve the remote coding experience


New/Revised Areas of Concern:• HIPAA Compliance

• Productivity and Quality

• Organizational Structure

• Policies and Procedures

• Employee Engagement = Communication

• Job Sustainability

• Educational Needs

• Remote/In-Office/Hybrid Office Structure for the Future



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HIPAA Compliance: Has COVID Put You and Your Organization At Risk?

Are Previous HIPAA Guidelines In Place By Your Organization Sufficient for Today’s Remote Coding Environment?

• The remote environment needs more stringent HIPAA security as the risk of security breaches is much greater and not as controllable as in the office environment

• Past policies should be reviewed/updated as needed and reviewed again with employees, signed and dated

• New policies should be implemented as needed for new guidelines needed in the remote environment



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HIPAA Requirement Checklist Ensure changes in remote environment due to pandemic has not placed

HIPAA or other security measures in danger such as children/spouses in home during work hours, viewing of passwords and accesses, PHI information by individuals previously not present during work hours

Transmittal of PHI information from remote computers

Evaluation of a BYOD (bring your own device) security for each remote environment/device

Evaluation of firewalls and VPN/network access to organizational systems

Ensure that all platforms, devices, systems and data for the organization meet minimum privacy and security standards

Maintain logs of remote access activity and review on a regular basis

Maintain a Media Sanitization Policy for the disposal of all PHI or devices contained PHI

Set policies in place for violation of any of the above policies

Maintain a log of all devices being utilized remotely by employees that access PHI including employee notification of any new devices PRIOR to use

EXAMPLES OF SECURITY BREACHES FROM A REMOTE ENVIRONMENT

Cancer Care Group - $750,000Remote employee lost laptop in car theft

Found guilty of failing to conduct company-wide risk analysis when breach occurred and not having a written policy regarding removal of hardware in/out of facilities

Lincare Respiratory - $240,0000Remote employee exposed/abandoned sensitive PHI information when information taken off-site despite employees worked in patients’ home routinely removed PHI from corporate office.



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Productivity and Quality: Have They Changed? Have You or Your

Organization Reviewed?

Are Current Productivity and Quality Standards Appropriate for the Remote

Environment?!

• Studies show that remote workers CAN average up to a 13% increase in productivity in a conducive environment.

• Since the possibility of distractions is greater and easier in the remote environment, it is essential to monitor these factors to watch for any significant changes both company-wide as well as each individual

• Studies found large gaps of unaccounted-for time as well as large gaps of time where employees were unreachable or did not respond to the organization’s communications



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Productivity and Accuracy Checklist

Have productivity and accuracy standards been reviewed/updated following conversion to remote environment

Have any changes or new standards to productivity and accuracy be communicated to the employees

Are productivity and accuracy by employee and organization been shared regularly with the employee

For those employees “forced” into remote employment, productivity and accuracy standards may actually decrease

Organizational Structure: Has It Been Updated to Accommodate Changes In

The World Around Us?



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Organizational Structure in the World of the Pandemic

• Review of organizational chart

• Possible addition of an “intermediary” such as liaison or task force, command center or chief communicator to coordinate remote communications

• Include employee representation on any type of committee reviewing remote communications

• Review each employee’s roles and responsibilities and make changes as needed to accommodate remote work environment

• Update all organization information, redistribute and conduct employee meeting if any significant changes are made

Policies and Procedures: Are There Policies and Procedures for the Remote

Work Environment?



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New Policies for Remote Work• Many organizations did not have specific remote work

policies and procedures prior to pandemic

• Need to update existing policies for areas that changed due to mandatory remote work

EXAMPLE:

Children at home policy may have previously indicated that working remotely did not equate to child care and that arrangements for children (school, day care, etc.) should be made.

However, this policy may need updated since during the pandemic, many employees/parents were forced to have children at home as schools and daycare centers were closed.

Policies and Procedures ChecklistWork at home policy review, revision and redistribution to

employees and signature by all partiesAdding a clause regarding specific times such as national

emergency when the organization may dictate changes in policy (such as mandatory remote work, children at home)

Work hours – may need to consider more flexible hours since many parents are home schooling their children which may/will affect productivity if working during school hours (depending on age of children)

Policy that clearly defines room or space allowed for workplace and statement by employees others are not allowed in this area during work hours or while accessing PHI

Formalized communication standard (start/stop, when an employee is not available, specified time an employee should respond to requests)

Policy on formalized meeting schedule and how they will be performed (Skype, Zoom, virtual meeting, etc.) and frequency



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Employee Engagement = Communication: Have You Been “Abandoned”?

MAINTAINING EMPLOYEE SATISFACTION AND ENGAGEMENT

• While 60% of remote employees prefer working remotely, employee sustainability has suffered

• 41% of remote workers to not feel connected to colleagues and the organization

• 26% of remote workers feel isolated

• Research showed that remote staff are twice as likely to receive corrective action, however, it is twice as likely to NOT be effective

• Result is a much higher turnover and employee dissatisfaction rate

Communication is KEY to maintain employee satisfaction, loyalty and a productive, quality contribution by employees



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Communication ChecklistDo not leave it to the remote coder to initiate communication

Do not leave communication (negative or positive) only to the performance review

Have regularly scheduled staff meeting

Encourage virtual live lunches or breaks, or schedule an on-line lunch by department or “Lunch and Learn” monthly

Communicate productivity and accuracy standards

Look for ways to empower, not regulate. Coders, by nature, are self-directed individuals, who need little daily regulation, but communication.

Make all staff meetings video and all camera “on” so that employees can interact personally rather than by phone or remote access

Job Sustainability: Efforts to Maintain and Keep Jobs



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FURLOUGHED, LAID OFF OR FEARING LACK OF WORK WILL RESULT IN DISMISSAL?

Medicine is medicine – no matter how and where it is practiced. Healthcare will continue, however, layoffs and job eliminations did occur, as they did in practically every facet of American industry.• >40% of employees converted to remote positions during the

pandemic will continue to work remotely once the crisis is over• 40% of remote employees were looking for more self-directed work.

Encourage managers to move away for directing the remote coders work and coaching them for success

• Employment of health information expected to grow 18.2% from now until 2028 primarily due to:

Increased use of EMRAging Population

Employee Sustainability and Employment Checklist

While remote may not be your preference, make the best of the situation

Participate in online staff meetings and any other organization-sponsored meetings such as virtual live lunches or breaks

Communicate any problems you are experiencing in adapting to the remote environment or possible need for changes to work schedule before they become a problem

Continue to grow your professional network – participate in virtual AAPC meetings and other virtual meetings

Select a new specialty field and/or additional certification

If seeking employment, consider engaging a professional recruiter and/or seek assistance on resume preparation



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Educational Needs: Meeting the Needs Outside The Office

MEETING EDUCATIONAL NEEDS EVEN IN THE REMOTE ENVIRONMENT

According to AHIMA “HIM Professional Census 2020”, three main concerns of employees regarding education are:

1 - Keeping up-to-date on annual changes to coding systems (ICD-10, CPT, etc.)

2 - Preparing for significant revisions to coding systems

3 - Staying current with advances in technology that affect the coder’s job



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TAKING CONTROL OF YOUR EDUCATIONAL NEEDS

• Employees may have to take control of their educational needs

• Offer to present a topic in monthly or scheduled educational sessions offer by employer

• Attempt to negotiate reimbursement of education needs through employer with continued employment and meeting productivity and accuracy standards

Remote/In-Office/Hybrid Office? Structure for the Future



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MAKING DECISIONS FOR THE FUTURE• Employers must monitor the success and failures of their current

remote environment• Employers should also monitor the costs of remote vs in-office, or

hybrid employment, not only in dollars but employee satisfaction, employee turnover

• Solicit opinions from employees regarding their preference• Identify employees that did not do well in the remote

environment but did well in-office and consider a hybrid environment if the organization has a number of these employees

• Employees should “self evaluate” their performance in the remote vs in-office environment and make decisions accordingly

REFERENCESAHIMA. (2018, November 13). Will Coders Ever Return to the Office. Journal of AHIMA. Retrieved from https://journal.ahima.org/will-coders-ever-return-to-the-office/

AHIMA. (2020, September 8). Journal of AHIMA. Using Change Management Strategies to Adapt to an Ongoing Remote Workforce. Retrieved October 9, 2020, from https://journal.ahima.org/using-change-management-strategies-to-adapt-to-an-ongoing-remote-workforce/

Bradley, V. (2020, March 30). MGMA. Shifting your medical coding staff to remote work during the COVID-19 pandemic. Retrieved October 7, 2020, from https://www.mgma.com/resources/operations-management/shifting-your-medical-coding-staff-to-remote work/



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REFERENCES (continued)

Forbes. (2020, April 16). Forbes. 15 Key Tips For Companies Implementing Formal Remote Work Policies. Retrieved October 7, 2020, from https://www.forbes.com/sites/forbescoachescouncil/2020/04/16/15-key-tips-for-companies-implementing-formal-remote-work-policies/

Rupp, S. (2020, July ). For the Record. The Pandemic's Effect on the Coding Market. Retrieved October 9, 2020, from https://for.the/record/the-pandemics-effect-on-the-coding-market/

THE END

Contact Information:

Marsha S. Diamond, CPC, COC, CCS, CPMA, AAPC Fellow

[email protected]

407-230-9000



Looking to 2021 - The Role of the Coder In the World of The … · 2020. 10. 12. · 1 Looking to...

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