One of our clients, The Orthopaedic Group, recently saw an 8x improvement in their coding productivity in less than 3 weeks. They achieved this incredible improvement by working as a team, overhauling their workflows, and implementing best practices. This huge increase in productivity is a direct result of their hard work and dedication to finding a win-win solution for all.

Finding win-win solutions that benefit both your clinical staff and your revenue cycle staff can be challenging. Often, back-office staff will use inefficient workarounds just to protect the clinical staff and MDs. Protecting clinical staff is a great thing. Back-office staff wants to empower clinicians to provide quality care to patients. However, that should not mean that back-office staff suffers or works in an inefficient manner. It is always worth it to search for a win-win solution. This is what The Orthopaedic Group discovered, and they are reaping the benefits.

36 Coding Hours Per Day

Because The Orthopaedic Group wanted to protect their physicians, they had their certified coders going behind their physicians and touching every single encounter. They ranked the charges and linked diagnosis and procedure codes. They would review the chart and make sure everything documented was included in the encounter. These 8 certified coders were spending 4.5 hours per person per day manually working on each encounter behind their physicians. That is 36 hours total per day just spent touching and manually reviewing encounters.

Analytics Sparked a New Proposal

This type of inefficient workflow is very common among many practices. The problem is, many practices don’t actually know how much time their coders are spending manually reviewing encounters. That is why analytic data is so important. The Orthopaedic Group was able to review detailed White Plume analytics, providing them with insight into how many hours their coders were spending reviewing encounters manually.

Not only did this data convince management that changing their workflows would be worth the hard work, but it also gave them backup for conversations with clinicians. As they asked clinicians to make a few small changes to their workflows, they were able to point to the numbers. They could prove that the changes were valuable enough to be worth the effort on the part of the clinical staff.

Once everyone was on board, 2 certified coders spearheaded the project. Jan, one of their certified coders, had this to say about changing their old workflow:

“We knew this was not the most efficient workflow and, with the encouragement of the White Plume staff and the support of our management we decided to start White Plume’s White Glove Process.”

The White Glove Process

Jan and Brandi, 2 of the 8 certified coders at The Orthopaedic Group, went to work quickly. Their dedication to the project is why it was such a great success. These two women worked diligently for four weeks, working out all the kinks before doing a full implementation with the rest of the staff.

The ultimate goal for their new, efficient workflow was to implement the best practice of exception-only coding. When coders practice exception-only coding, they only stop to review encounters with errors. They do not spend time manually reviewing every single encounter. Instead, they allow AccelaSMART, or whatever rules engine they use, to stop them when it is necessary. This requires trusting the technology to catch important mistakes.

In order for The Orthopaedic Group to implement exception-only coding, they needed to do 3 steps.

• First, they needed to make a list of all the changes they manually code on a daily basis.
• Second, they needed to turn that list into rules and scripts in AccelaSMART.
• Third, they needed to test it out before going live with their entire team.

First, they nailed down a list of the changes they most commonly make on encounters. These are all the changes that the coders were previously changing manually. Jan and Brandi made weekly conference calls with White Plume staff, making sure they thought of everything they needed.

Next, they worked with White Plume staff to analyze coding changes. They worked together to determine which coding changes could be automated, and which changes needed coder review.

Finally, Jan and Brandi spend 2 weeks using the new exception-only workflow to test it out. They made sure that it would work seamlessly before finally having an implementation with the rest of the team.

The Results – 4.5 Coding Hours Per Day

The Orthopaedic Group saw amazing results for their hard work. After only 3 weeks of using this new workflow, the team at The Orthopaedic Group saw an 8x improvement. They went from spending 4.5 hours per coder per day, to spending 4.5 hours total per day. On average, each individual coder only has to spend 30 minutes a day reviewing encounters.

This incredible accomplishment allows them to reallocate work, making their revenue cycle 8x more efficient than it was before. As The Orthopaedic Group continues to work with White Plume, they will continue to see even more improvements in their productivity.