"I am one part detective, one part medical interpreter,” says Valerie Woodward, who works from home as a coding specialist.
She may work in bunny slippers while sitting in front of a (fake) fireplace, but, make no mistake, Valerie Woodward is involved in the serious business of ensuring our patient records are accurate—which means, in part, that patients are charged correctly and we’re reimbursed appropriately for services provided.
“What I do directly affects so many areas, including publicly-reported data, physician profiles, the patient’s pocketbook and Fairview’s paycheck,” says Valerie, compliance and reimbursement analyst on the University of Minnesota Medical Center inpatient coding team.
Coding specialists interpret inpatient and outpatient records and assign a code to each action or service provided by the care team. By guaranteeing each aspect of a patient’s visit is coded correctly, coding specialists ensure that patient record data about the patient’s illness and treatment is accurate. The correct information is vital for reporting, research initiatives and for proper reimbursement for services rendered.
What they do
Fairview employs approximately 75 coding specialists in three different departments--inpatient, outpatient and professional fee--who assign diagnosis and procedure codes and the level of service charged by each physician.
Inpatient coders are expected to complete 2.3 patient files per hour, or about 17 a day. That number is much higher for outpatient coders like Kristine Nelson, a member of the Fairview Ridges Hospital outpatient coding team. Kristine estimates she works on up to 300 patient accounts each day. All teams have precision standards, as well; for example, Valerie’s team expects 95 percent accuracy.
“Quality coders are vital to the health of the organization,” says Pat Gastonguay, system director of Health Information Management Services. “The codes they assign, based on physician documentation, are used for patient severity metrics, reimbursement, disease trending, quality reporting, hospital and physician performance profiles and research. We have a great team of coders who are always ready to learn more and help improve documentation. “
Coding specialists are typically required to work on-site at their hospitals for at least a year before being allowed to work from home. Once he or she reaches productivity and quality standards consistently, the coding specialist can begin working from home.
“We are not islands: we work very closely with our supervisors and our co-workers, and the Health Information Management support staff,” explains Kristine. She notes that her team has monthly in-person meetings, as well as occasional social gatherings.
Why they do it
“I love what I do, it’s a perfect fit,” Valerie says. “I love research; I love digging. I am one part detective, one part medical interpreter.”
Though she does not physically touch or see patients, Kristine says she feels like a very important part of the Fairview care team.
“This is real money and these are real people,” she says. “My contact with patients may be indirect, but I feel like I have an impact on how they view Fairview. We have integrity and we try to do as much for patients as possible.”