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HEALTHCARE COMPLIANCE

Question Description


Competencies:
7027.1.1: Structure and Organization of the Coding Function – The graduate analyzes the role of a coding professional within a health information management department.
7027.1.2: Staff Recruitment and Retention – The graduate evaluates candidate qualifications for the purpose of recruiting, hiring, and retaining health information management departmental staff.
7027.1.3: Charge Description Master – The graduate explains how the charge description master (CDM) committee impacts the revenue cycle.
7027.1.4: Coding Performance Management and Process Improvement – The graduate develops strategies for maximizing coding productivity and quality standards.


Task 1: Coding Management

Introduction:

Today’s healthcare organizations know the importance of accurate coding and charge capture, which are essential to the process of revenue management. Health information management professionals may have responsibilities in coding management, in clinical documentation improvement, managing internal auditing and managing external auditing in response to governmental audits. Coding managers understand the essential job functions of their staff and develop productivity and quality standards to maximize efficiency within the department. They recruit and hire staff and also evaluate staff qualifications based on changing workforce needs. Accuracy in charge capture, coding, and clinical documentation is critical to the financial success of the healthcare organization. It takes a team of qualified and knowledgeable professionals to maintain a successful revenue cycle.

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

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A. Analyze the various responsibilities of a coding manager by doing the following:

1. Describe the responsibilities of inpatient and outpatient coders within a healthcare organization.

2. Describe the purpose of a clinical documentation improvement (CDI) program.

3. Explain how you would evaluate the qualifications of potential coding candidates for employment.

4. Explain strategies that focus on staff retention.

B. Explain how the responsibilities of the charge description master (CDM) committee bring coders, billing staff, and CDM staff together to ensure revenue cycle success.

C. Develop strategies for improving both coding accuracy and coding productivity, and explain how a coding manager would use these strategies.

D. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.

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