Comparing performance is a common business strategy

Full Answer Section

• • Timeliness: Timely coding is crucial for efficient revenue cycle management. Standards emphasize meeting deadlines for coding and abstracting patient information.
  • Compliance: Adherence to all applicable coding regulations, including those from Medicare, Medicaid, and other payers, is essential to avoid penalties and ensure ethical coding practices.
  • Productivity: Coding productivity is a key performance indicator. Standards may include guidelines for acceptable coding productivity levels, considering factors like case complexity and coding staff experience.
  • Data Quality: Accurate and complete coding is essential for high-quality data. This includes ensuring data integrity, consistency, and compliance with data quality standards.
• Other Resources:
  • National Center for Health Statistics (NCHS): Provides data and resources on healthcare quality and coding.
  • Centers for Medicare & Medicaid Services (CMS): Publishes coding guidelines and regulations for Medicare and Medicaid programs.
  • The Joint Commission: Sets standards for healthcare quality and safety, which include accurate and timely coding.

II. Coding Dashboard Design

1. Coding Accuracy:

• Metric: Coding Accuracy Rate
  • Calculation: (Number of accurately coded records / Total number of coded records) x 100
  • Data Source: Internal coding audits, external audits (e.g., by payers or third-party reviewers)
  • Graph:
    • Bar Chart: Compare coding accuracy rates across hospitals, clinics, and the long-term care facility.
    • Line Graph: Track coding accuracy trends over time (e.g., quarterly or monthly) for each facility.

2. Coding Productivity:

• Metric: Codes Per Hour (CPH)
  • Calculation: Total number of codes / Total coding hours worked
  • Data Source: Coding time tracking systems, productivity reports
  • Graph:
    • Bar Chart: Compare CPH across different coders, departments, and facilities.
    • Scatter Plot: Analyze the relationship between CPH and case mix complexity (e.g., DRG weights).

3. Length of Stay (LOS):

• Metric: Average LOS for specific DRGs or patient populations
  • Data Source: Hospital information systems (HIS)
  • Graph:
    • Box Plot: Compare LOS for similar patient populations across different hospitals.
    • Line Graph: Track trends in LOS over time for specific DRGs or patient populations.

4. Case Mix Index (CMI):

• Metric: CMI for each hospital/facility
  • Data Source: HIS, DRG grouper software
  • Graph:
    • Bar Chart: Compare CMI across hospitals and compare to national benchmarks.

5. Accounts Receivable Days:

• Metric: Average number of days to collect outstanding accounts receivable
  • Data Source: Revenue cycle management system
  • Graph:
    • Line Graph: Track trends in accounts receivable days over time for each facility.

III. Dashboard Features

• Interactive elements: Allow users to filter data by facility, department, time period, and other criteria.
• Drill-down capabilities: Enable users to explore data in more detail, such as investigating the root causes of low accuracy or high LOS.
• Benchmarking data: Include national and regional benchmarking data to compare performance against industry standards.
• Alerts and notifications: Set up alerts to notify managers of potential issues, such as significant drops in accuracy or increases in LOS.

IV. Data Tables

• Include detailed tables with underlying data to support the graphs and provide additional insights.
• Example:
  • Table 1: Coding Accuracy Rates by Facility and Month
  • Table 2: CPH by Coder and Department
  • Table 3: Average LOS by DRG and Facility

V. Data Sources

• Hospital Information Systems (HIS)
• Coding software
• Revenue cycle management systems
• Internal audit reports
• External audit reports
• AHIMA resources
• CMS data
• Industry benchmarking databases

VI. Data Visualization Tools

• Microsoft Excel: For creating basic charts and graphs.
• Power BI: A powerful business intelligence tool with advanced data visualization capabilities.
• Tableau: Another popular data visualization tool with a user-friendly interface.

VII. Data Security and Privacy

• Ensure compliance with all relevant data privacy and security regulations (e.g., HIPAA).

VIII. Ongoing Monitoring and Improvement

• Regularly review and update the dashboard to reflect changes in coding practices, industry standards, and performance goals.
• Use the dashboard to identify areas for improvement and implement corrective actions.
• Conduct regular training and education sessions for coding staff to improve skills and knowledge.

Sample Answer

Certainly, here's a framework for a coding dashboard to benchmark coding performance across your healthcare system, incorporating national standards and relevant metrics.

I. Research & Standards:

• AHIMA Standards:
  • Accuracy: High accuracy in coding is paramount. Standards emphasize adhering to official coding guidelines (ICD-10-CM, ICD-10-PCS, CPT) to ensure correct assignment of codes.
  • Completeness: All relevant diagnoses and procedures must be accurately and completely coded to maximize reimbursement and ensure data integrity for clinical and research purposes.