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Retraining a coder

  1. #1
    Rose City (Portland, Oregon)
    Default Retraining a coder
    Medical Coding Books
    I'd like some imput on new ways to train someone how to code. I have used all the tools in my bag of tricks and nothing has been successful so far:

    1. Have coder fill out audit sheets and go over each service in person in order to talk about coding difference.
    2. Sit with coder as she codes and have her talk through her process so that problem areas can be identified and addressed.
    3. Start from scratch (What is HPI? ROS? etc...)

    I try to give positive feedback and encouragement whenever she does the slightest thing right. I've asked her how she learns best (see above) but the improvement has been miniscule. This person has been a coder, CPC certified, for years. She is an excellent employee in all other respects and I'm committed to helping her.

    Any helpful thoughts or suggestions would be greatly appreciated.


  2. #2
    When she codes have her look up the guidelines and keep them on file for reference.

  3. #3
    It seems as if you are doing all of the right things... You know sometimes we get so used to doing things "our way" - whether or not it is correct that we close our minds to the possibility that it may have not been the right way.

    You can lead a horse to water.... but you can't make them drink... You may have to walk away and come back later.
    Felicia A. Thomas, CPC
    Atlanta, GA

  4. #4
    This can be done as a fun spirited challenge or assessment within the office if approached carefully...

    I'd recommend you have her audit another coder. This one being a high performer that you want her to be more like. Have them each to a 5 chart challenge coding the same 5 encounters in a "showdown." Once complete, let them assess each other, and meet with them both (you acting as facilitator) to see what you can learn.

    Announce the "winner" and schedule a rematch in 30 days. Keeps doing it with various staff members, if needed, but make sure the focus is on quality and back to basics refreshers. She'll probably respond to this. I've found it helpful with our teams.

  5. #5
    Stuart, Florida
    I'd be a bit weary of making it a competition. Nobody wants to be compared to someone else in that capacity, especially when the person you're being compared to is already a seasoned, well-trained, coder with plenty of experience under their belt. You don't want to give your trainee a complex. Depending on the people, it very well could work out as "fun spirited", however, there is a good possibilty that it could turn out that you make someone feel inadequate. I suppose that you would be able to feel out the situation but I know that I would not want to pit my employees against each other. I keep hearing, "Two men enter, one man leaves.", repeating in my head. Lol. Pointing out that one employee is not as good as the other, in a "showdown" situation while announcing a clear "winner", can become really discouraging to the "loser", you know?

    Maybe I'm just being too empathetic...
    Vanessa Mier, CPC

  6. #6
    I concur with Vanessa. Research has shown that productivity suffers as a result of competition.

    I have seen the physical and emotional effects of working in a production-driven coding company as well as the drop in accuracy when coders try to meet production goals. I cannot imagine the added stress it would add to compete with others. For me, it would not provide an atmosphere conducive to learning.

    Andersee, I applaud your efforts. We need more professionals like you!

  7. #7
    Rochester NY
    It's unfortunate that you have hired a CPC that does not code well.
    Don't take this the wrong way, but just because she has held her CPC credential for years doesn't necessarily mean she has been working as a CPC for years.

    Is she out of practice in coding? Is she up to date on guidelines? Does she know where to look to find the answers to questions? I'm going to assume that the answer is yes.

    Another thing that is unfortunate, is that when you call for a reference all they can say is yes the person worked here. It's too bad that a real reference can not be done, because sometimes it serves the new potential employer a real injustice to not know the real truth about a persons capability to perform a job.

    Maybe coding is not what this person should really be doing.

    As far as her training is concerned, does your office have some kind of training program that new coding staff attends? Not knowing how long the person has been employed with you, she might know you're not satisfied with her skills if all of a sudden you throw her into a "newbie" coding class.
    But, apparently she needs it.

    All offices should have productivity standards - you need a measurable goal for all staff. In my office, we have weekly audits that are weighed as part of our performance evaluation. If we don't obtain a certain accuracy goal, training is required, and the "consequence" deepens if the accuracy is not improved.
    We need to have competant coders on our teams. Practices depend on having a staff that knows how to do their jobs well. Too much money is at stake, in many aspects (not just visit recievables) to have coders -and billers for that matter - who can not perform at an acceptable level.

    Good luck
    A. Judd

    2013 President, Flower City Professional Coders
    2012 Vice President, Flower City Coders local Chapter
    2011 Member Development Officer, local chapter

    "You cannot truly listen to anyone and do anything else at the same time." M. Scott Peck

  8. Default
    I empathize with you. I, too, was in a situation where someone was hired who had their certification but no experience in coding. Even worse, she was a friend of my manager(the same person who decided to hire her). I gave the candidate a coding test before she was hired and she didn't know any of the answers!! It was a nightmare. Finally, after nine months of hitting my head against a wall, she was transferred to another department. The work I do is multi-facted as many of us can agree, from auditing to coding procedures to denial management for a clinic with over 60 physicians. Part of the issue is that this coder was hired in the first place, knowing she had no experience nor the open mindedness to accept help.

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