Relieve Coding Stress: Help Your Ticker

Improve, manage, or eliminate stress for a healthier heart.

By Michelle A. Dick

Coders may code conditions and services related to heart disease, but the nature of coding and billing as a profession can also make heart diseases a personal issue.

Since 1963, Congress has urged Americans to join the battle against heart diseases and required the president to proclaim February as “American Heart Month.” The American Heart Association led initial awareness efforts with the goal of teaching about heart disease and stroke, and to raise money for research and education.

Avoid the Factors Leading to Heart Disease

Being heart smart means that you:

  • Monitor your cholesterol and triglyceride levels, blood pressure, waist size, and body mass index (BMI). These major factors determine heart health. Schedule a checkup with your physician if you don’t know these.
  • Don’t smoke. Smoking causes respiratory problems and lung cancer, and it’s a major cause of heart disease.
  • Exercise and eat healthy. These are two most proactive things you can do to maintain a healthy heart.
  • Reduce stress. While some stress is a normal part of life, excessive stress is the cause of many ailments such as insomnia, headaches, upset stomach, and even coronary artery disease.

It’s nearly impossible to eliminate all life’s stresses, but there are many ways you can reduce stress in your daily coding life.

Identify Stress that Coders Face Daily

Although not directly involved in the stresses of providing medical care, coders and billers encounter stress in other ways.

For example, coding stress can stem from not meeting coded chart quotas, physicians documenting incorrectly, vicarious trauma, trying to keep up with payer guidance and coding changes, and not having a good knowledge of medical terminology and anatomy.

Medical billing stresses may involve having to explain charges, deal with criticism, give and receive feedback, be assertive, manage databases, and communicate effectively when a patient, insurance company, or client asks questions.

Procrastinating on preparing for inevitable changes in our industry, such as ICD-10,  can also cause stress.

Reduce Coding-related Stress

Too much stress interferes with concentration and productivity and reduces physical and emotional health, so it’s important to find ways to keep it under control. There are a variety of steps you can take to reduce both overall stress levels and the stress you find in the work environment. These include:

Find an Outlet to Relieve Your Stress.

For example, exercise, pray or meditate, or read or write. These things work for Janet L. Dunkerley, CPC, CPC-I, CMC, PCS, senior consultant for QuadraMed. To promote overall well-being, she meditates and practices yoga. She said, “I meditate daily and don’t let minor things bother me. Keeping a positive attitude in a negative situation always seems to work for me.” She continued, “It calms me down and allows me to deal with unpleasant situations in a rational manner.” Dunkerley realizes that she cannot always change the situation around her, but she can change how she deals with it. She said, “I also practice yoga. I find that if I take care of my mind and my body, everything else just seems to fall into place.”

Identify and Change Negative Attitudes that Add to Work Stress.

For Susan Edwards, CPC, dealing with unprofessional attitudes is one of her biggest stresses while coding outpatient facility/physician claims at a critical access hospital in rural Vermont. She admits, “The most frustrating and stressful part of my job is dealing with unprofessional people.” She said the best way for her to handle and overcome this stress is “to get a cup of coffee, take deep breaths, and try to focus on another area of work until I can approach the stressful situation in a clear, level-headed way.” Strengthening communication skills to ease and improve relationships with management, coworkers, and patients also help to reduce attitude-related stress at work.

Use Task Management to Prioritize Your Workload.

Do tasks in the order of importance. Analyze your schedule, responsibilities, and daily tasks. If any task is unpleasant to do, get it done early in the day. Once the daunting task is done, the remainder of the day will be easier. Break projects into small steps. If a large project seems overwhelming, make a step-by-step plan. Focus on one manageable step at a time, rather than taking on everything at once.

When it comes to managing work tasks, know how much work you can handle and try not to over-commit yourself or you’ll set yourself up for failure. If you do take on too much work, delegate some of the responsibility. Unite with co-workers. Help co-workers when they need help and others will assist you in times of stress. Just knowing that someone’s got your back will reduce your stress level.

Arlene J. Kelley, CPC, is a medical coder for a multi-specialty group in Duluth, Minn. who has a heavy workload. She says there are “not enough hours in the day to get the work done.” To manage her overabundance of work, she said, “I pace and organize myself. I deal with it—first in, first out.” She admits, “I really don’t overcome it, but vacation helps.”

Don’t let your heavy workload carry into your home life. All work and no play is a recipe for burnout. Find a balance between work and family life, social activities and daily responsibilities, and downtime.

Find Humor and Reasons to Think Positive.

Think positive. Negative thinking drains your energy and motivation. Find humor in work and life’s unpleasant and stressful situations. When you, or your co-workers, start taking things too seriously, break through the tension with laughter. Share a joke or funny story. Humor works for Shreka Rogers, CPC, CMRS, CMSCS. She uses laughter to cope with stress because “Most of the time eliminating stress is not an option.” Rogers said, “I keep a sense of humor by finding fun ways to help me and my staff learn. For instance, we played coding Jeopardy to learn the 2012 procedure code updates.” She added, “The staff had a great time and they were able to learn and retain the information.”

If humor doesn’t work on a co-worker with Eeyore’s attitude, stay positive and only engage with them when necessary for completing job tasks. You don’t want their unpleasant, bad attitude affecting your positive demeanor.

When Stress Takes Over, Switch Gears.

Take a mental break from the stress. Leave the stressful situation, project, or coding assignment and come back with a clear head. Plan short breaks or complete a short, less daunting task first. Rena Hall, CPC, who works in billing/collections at KC Neurosurgery Group, LLC., uses this de-stress technique “when dealing with the monetary elements for the office (coding, billing, insurance follow up, and collections).” She finds keeping the accounts receivable “tidy” as being particularly stressful. Hall said, “Some patients tend to be less than pleasant when we ask them for payment while collecting for the services provided.” She continued, “To deal with this stress, I am fortunate to work in an office that allows me to vary my duties on a daily basis. If I feel overwhelmed, I can set the job aside and work on something else for a while.” She added, “There is always a lot to do at my desk!”

Remain Calm

Managers can be the key to helping keep stress levels in the workplace to a minimum. Good managers act as positive role models, especially in times of high stress. All of the tips mentioned in this article are twice as important for managers to follow. If someone you admire remains calm, it is much easier to remain calm yourself.

If none of these de-stressing techniques work, remember that trained, professional medical billers and coders are in high demand. It’s your health at risk. When work is unmanageable, don’t be afraid to look around for a less stressful position.

13 Tips for Managing Coding and Billing Stress

Lorraine J. Sivak, CPC, is a billing/office manager for Joseph J. Sivak, MD and Troy D. Otterson, MSW, LICSW. As the medical office administrator, she is responsible for all functions of the small medical practice, including billing and coding. Outside of direct patient care, she said, “My most stressful part of the job is education and keeping current with insurance company rules and regulations, the ever-changing federal guidelines, and EHR and electronic prescription (eRx) guidelines. Managing all of this information and deciding what is most relevant to each provider, is time consuming and most times overwhelming.”

Sivak said, “I have not found a way to eliminate the stress associated with having to ‘know’ and keep up with all the changes.” Because she can’t eliminate the stress, she has created tips to help manage her stress-related demands:

1.    Network with other office administrators from other facilities in the community.

2.    Network with AAPC coders and billers.

3.    Network with other facilities in the same specialty.

4.    Take the time to read through insurance company updates and alerts.

5.    Subscribe to the Centers for Medicare & Medicaid Services (CMS) newsletters.

6.    Use Medicare Learning Network and navigation for insurance information portals.

7.    Stay ahead of changes and plan for the implementation of those changes.

8.    Keep open and honest communication with all employees and keep them informed of issues as a team.

9.    Realize that no “one” employee should be kept out of the loop.

10.  Make a reference notebook on issues that have been solved and how to solve it for future use.

11.  Organize necessary information, weed out irrelevant information, and have a system to access it.

12.  Don’t be afraid of change.

13.  Rest, relax, walk, and take care of yourself, so you can do it all again tomorrow.

Although Sivak has not overcome coding and billing stress, she recognizes it’s there and manages it. Sivak said, “I am a list person, so every week I sit with my calendar and figure out what has to be accomplished for each week.” She said, “Using the list and planning, as best I can, is my lifesaver.”



Michelle Dick
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Michelle Dick

Executive Editor at AAPC
Michelle A. Dick has been executive editor for AAPC for over seven years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. Dick has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.
Michelle Dick
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About Has 133 Posts

Michelle A. Dick has been executive editor for AAPC for over seven years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. Dick has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.

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