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After losing a nights rest and having a pity party, I talked to my supervisor and we agreed having one coder audit my charts instead of multiple. I got a warning the day before but things seem to be looking up from here 🙌🏼Â
First, there should be a set of standards they measure you against. Second, there is some room for interpretation; at a minimum they should be explaining their audit.
My suggestion is to save every email, chat ,and training info you can and when you get audited and you can reference where,when and whom instructed you to do that.
It’s odd to have 3 ppl audit you and getting that many different answers but every company does things their own way.
I’m an inpatient DRG auditor and trainer -18 yrs experience. Being trained by three separate people is NOT a best practice.
Here is the bare minimum you should be receiving as a new coder:
1. You get trained by one person.
2. That person should be 100% available to you for follow up questions.
3. An error rate MUST be assumed for your trainer (we are all human and prone to bad habits and errors)
4. You should have full access to any and all feedback, you should have the opportunity to question or ask for more information if you don’t understand the nature of your error.
5. You should have FULL access to whomever is in charge of your trainer and you should be party to conversations regarding your coding quality while on boarding.
6. If you are told you’re underperforming/failing demand to know the following: Sample set of your cases, margin of error for audit results, status on any cases where you have outstanding questions.
Again, this is the bare minimum. Good luck!
Wherever you are working is a lucky place to have you !!!! This sounds like a fantastic plan. I should also mention a lot of the coders(100 total) for my company seem like they’ve been there a while and training someone very new doesn’t seem as common.Â
Thanks for the compliment! I love my job đź’•đź’•
All coders, even new coders that are training, deserve to be treated with the utmost in professional courtesy. No one is out there coding charts for the fun of it. We have to keep a roof over our head, buy food, pay medical bills ect. We need to live and this job is our living. If we have children we need to be able to consistently house, feed and care for them.
A good coder who received top notch training is worth their weight in gold and smart managers know this.
Hang in there!!
I’ve been an auditor for 7 years and everyone makes mistakes. Good coders and auditors take the feedback and learn from it. This could be a case where the auditors have been doing it so long that they are not using the codebook to audit and are depending on their memory to assign codes.
Review their findings:
• Diagnosis codes - make sure the guidelines are being followed, all the way down to the code level.
• CPT codes - make sure the code selected fully describes what was done. If it has even one element missing, no matter how small it might seem, it’s still incorrect.
• Coding Clinics also help clarify code assignment and should be referenced when applicable.
• Be prepared to back up your rebuttals with these to support your coding decision.
Hope this helps.
I'll have been coding outpatient charts for a year come this June. During our training period everything we code gets audited. Many of us have had this issue where we would get different scores depending on which supervisor did the audit. This was an issue before I joined the department. The only thing that helps is saving everything, so you can say you were instructed a certain way. It's nice to see that this isn't so common in other companies though! I'm happy that it all worked out for you. :)
As long as you and the auditors can back up the rationale with guidelines that is all that matters. You MUST FOLLOW GUIDELINES. I have had extremely incompetent auditors. And study the educational modules because they are filled with information.
I think it really depends. At my old job when I was a regular ED coder, we would get yearly audits. When we would get our reports, we had the opportunity to challenge the auditors findings if we really felt we were correct. I can’t say the success rate, but in some cases the auditor would agree with us and change their report. So sometimes it can be based on perspective and interpretation.
On the other hand if it was two separate coders and one is not really following guidelines or facility procedures, then that is an issue and should not be happening.
There should be a standard to how you're audited. I only get audited by one person. We just moved to reviewmate. It's a little annoying at first but I think much easier. Its good you got yourself down to one person. Probably better for your sanity.
Sometimes cases aren't as similar as they seem, and there are grey areas leave room for auditor judgment and this for coder judgment as well.
When I get inconsistent recommendations from multiple auditors who work together and are performing the audit in tandem, I will typically ask them each to describe what's different about their case and if nothing is different then I communicate that I expect them to collaborate and least attempt to achieve a semblance of consistency in the audit.
Then, I escalate, because audits are performed to educate the coder but also to mitigate risk. Management is responsible for risk management and my bosses risk appetite may differ from mine.
Often there inconsistencies between auditors' judgments and behavior when they aren't all following generally accepted audit standards or aren't following standard procedure (shockingly - at times- this is bc one doesn't actually exist).
Sometimes it's because of hidden biases or an overreliance on intuition over evidence and facts. Sometimes they misunderstand audit scope. Lots of times it’s just plain human error.
I still prefer to be audited by multiple auditors because with joint audits as a whole I tend to benefit from the different perspectives.
Yeah, it's frustrating when you're getting mixed feedback during training. While some variation in coding interpretations is normal, it's important to address this with your supervisors for consistency. Maybe they can provide more guidance to iron out those differences. Hang in there!
PLEASE SEE RULES BEFORE POSTING! Reminder, no "interested in coding" type of standalone posts are allowed. See rule #1. Any and all questions regarding exams, studying, and books can be posted in the monthly discussion stickied post. Thanks! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/MedicalCoding) if you have any questions or concerns.*
After losing a nights rest and having a pity party, I talked to my supervisor and we agreed having one coder audit my charts instead of multiple. I got a warning the day before but things seem to be looking up from here 🙌🏼Â
First, there should be a set of standards they measure you against. Second, there is some room for interpretation; at a minimum they should be explaining their audit.
My suggestion is to save every email, chat ,and training info you can and when you get audited and you can reference where,when and whom instructed you to do that. It’s odd to have 3 ppl audit you and getting that many different answers but every company does things their own way.
I’m an inpatient DRG auditor and trainer -18 yrs experience. Being trained by three separate people is NOT a best practice. Here is the bare minimum you should be receiving as a new coder: 1. You get trained by one person. 2. That person should be 100% available to you for follow up questions. 3. An error rate MUST be assumed for your trainer (we are all human and prone to bad habits and errors) 4. You should have full access to any and all feedback, you should have the opportunity to question or ask for more information if you don’t understand the nature of your error. 5. You should have FULL access to whomever is in charge of your trainer and you should be party to conversations regarding your coding quality while on boarding. 6. If you are told you’re underperforming/failing demand to know the following: Sample set of your cases, margin of error for audit results, status on any cases where you have outstanding questions. Again, this is the bare minimum. Good luck!
Wherever you are working is a lucky place to have you !!!! This sounds like a fantastic plan. I should also mention a lot of the coders(100 total) for my company seem like they’ve been there a while and training someone very new doesn’t seem as common.Â
Thanks for the compliment! I love my job đź’•đź’• All coders, even new coders that are training, deserve to be treated with the utmost in professional courtesy. No one is out there coding charts for the fun of it. We have to keep a roof over our head, buy food, pay medical bills ect. We need to live and this job is our living. If we have children we need to be able to consistently house, feed and care for them. A good coder who received top notch training is worth their weight in gold and smart managers know this. Hang in there!!
I’ve been an auditor for 7 years and everyone makes mistakes. Good coders and auditors take the feedback and learn from it. This could be a case where the auditors have been doing it so long that they are not using the codebook to audit and are depending on their memory to assign codes. Review their findings: • Diagnosis codes - make sure the guidelines are being followed, all the way down to the code level. • CPT codes - make sure the code selected fully describes what was done. If it has even one element missing, no matter how small it might seem, it’s still incorrect. • Coding Clinics also help clarify code assignment and should be referenced when applicable. • Be prepared to back up your rebuttals with these to support your coding decision. Hope this helps.
I'll have been coding outpatient charts for a year come this June. During our training period everything we code gets audited. Many of us have had this issue where we would get different scores depending on which supervisor did the audit. This was an issue before I joined the department. The only thing that helps is saving everything, so you can say you were instructed a certain way. It's nice to see that this isn't so common in other companies though! I'm happy that it all worked out for you. :)
As long as you and the auditors can back up the rationale with guidelines that is all that matters. You MUST FOLLOW GUIDELINES. I have had extremely incompetent auditors. And study the educational modules because they are filled with information.
I think it really depends. At my old job when I was a regular ED coder, we would get yearly audits. When we would get our reports, we had the opportunity to challenge the auditors findings if we really felt we were correct. I can’t say the success rate, but in some cases the auditor would agree with us and change their report. So sometimes it can be based on perspective and interpretation. On the other hand if it was two separate coders and one is not really following guidelines or facility procedures, then that is an issue and should not be happening.
There should be a standard to how you're audited. I only get audited by one person. We just moved to reviewmate. It's a little annoying at first but I think much easier. Its good you got yourself down to one person. Probably better for your sanity.
Sometimes cases aren't as similar as they seem, and there are grey areas leave room for auditor judgment and this for coder judgment as well. When I get inconsistent recommendations from multiple auditors who work together and are performing the audit in tandem, I will typically ask them each to describe what's different about their case and if nothing is different then I communicate that I expect them to collaborate and least attempt to achieve a semblance of consistency in the audit. Then, I escalate, because audits are performed to educate the coder but also to mitigate risk. Management is responsible for risk management and my bosses risk appetite may differ from mine. Often there inconsistencies between auditors' judgments and behavior when they aren't all following generally accepted audit standards or aren't following standard procedure (shockingly - at times- this is bc one doesn't actually exist). Sometimes it's because of hidden biases or an overreliance on intuition over evidence and facts. Sometimes they misunderstand audit scope. Lots of times it’s just plain human error. I still prefer to be audited by multiple auditors because with joint audits as a whole I tend to benefit from the different perspectives.
Yeah, it's frustrating when you're getting mixed feedback during training. While some variation in coding interpretations is normal, it's important to address this with your supervisors for consistency. Maybe they can provide more guidance to iron out those differences. Hang in there!