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The Work of a Coder: Survey Comments

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I love my physicians but sometimes I think that they think the coders are the bad guys because we give them back charts to dictate as well as needing more information. We don't have the same relationship as the other administrators in our office. Everybody is laughing and having great relationships with everybody else, except for us. We have to be in an office together (3 coders) and trudge away coding, trying to make ends meet at the end of the month, while is seems like everybody else isn't even working. The coders put in a ton of hours. We get tired real fast, but know we have to keep moving forward. Sometimes I wish I could be the one out there building relationships with the physicians to let them know that we do have a personality and that we're not the bad guys.

We use an EMR where the providers have to code their dx, procedure, E/M and then the coders are expected to audit as many as possible.  Sometimes the providers can not locate the diagnosis/procedure so the first dx is entered, not always the most specific, but usually in the category.  Also the exclusion notes are not available in the electronic software.  Coders always need to use the coding books!

Too much work and not enough coding hours to get it done in a timely manner.  The management team says they understand but nothing ever seems to change and they over hire in the nursing dept and we get threatened with manditory overtime if we don't work harder and faster. If they could spend more on the coding dept, the bottom line would jump by thousands of dollars.

Overworked, dysfunctional tools, inefficient processes. 

So much work, so little time.

It has been my experience that Physicians want everthing in writing to prove your position and yet they provide nothing to hold up their position.  I have met with resistance and outright anger when I have asked the physicians to correct, complete or comply with whatever would be necessary to warrant the code  they wish to be sent on to the insurance company.  Now I just downcode the fee ticket if it is not documented it was not done.

I am not clear as to what the expectations should be when coders don't have the support needed to encourage accuracy and are not valued as an important assest to the company. I often feel like the attitude of my employer is that "anyone can code" therefore we are not highly motivated to take on new task or to seek better ways of coding. In other words, not support system.

Physicians need to understand that coders have very specialized training just like they do and just because a Physician has not heard of a certain "coding guideline;" that doesn't mean the guideline is invalid.  I feel all Physicians should attend coding seminars each year along with maintaing their CME's.  This should be written in their contracts.

There is no way to learn anything new or upgrade skills here.  I get CEUs from  Edge Blast and complete them at work.  My supervisor gets upset when I work on  CEUs because it takes time away from productivity/numbers.  Coding is done for  coding's sake and no importance is put on ability to get claims paid.  The  billers hate the coders and the coders hate the billers.  I come from coding/  insurance resolution background and there is no similar job here.  Very little  resemblence to what I learned in AAPC coding course.

Our coders are extremely overworked and we need more help. PQRI has been a nightmare that has slowed us down!

The documentation performed by most of my physicians is appalling.  Furthermore, we have a poor EMR system and IT staff and have to make do with it.

One of the biggest challenges I face is to adapt all the old habits of the more experienced physicians who "always" did their billing a certain way 15 years ago.  Comment re: recently licensed physicians:  Tend to be more proactive with the business aspect of running a medical practice.

I think that all employers are expecting their staff to work harder and faster.  If quality suffers, then so be it.  Keeping up with the ever changing coding world requires time to read and research and time is not alloted for this any longer.  I think the job of a coder has become more stressful somewhat due to the productivity expectations, but also with the challenge of keeping up with payer's rules which seem to be more varied than ever before. I would like to see our coding association work with legislature to regulate Medicare, public aid, and insurance companies so that we don't have so much variance in rules and coverage.

In my work environment, my direct supervisor and director are not certified and are not coders.  We are a small compliance department for a large multi-specialty physician practice and although we do auditing and education about 50% of the time, most of the work day is spent on clerical tasks--stats, spreadsheets, etc.  I feel as though we are viewed as certified secretaries.

Providers do not want to accept that they have guidelines that must be followed.

Very large practice.  Have several physicians that are awesome and the rest think we are out to get them.

There seems to be a lack of knowledge of what a certified coder represents to a physician

Always trying to explain to our employer (CEO,mangers,directors,etc) why our coding jobs are relative and viable to the practice. It's a constant struggle just trying to hold on to our jobs. There isn't any more job security. The coders are trying their hardest to help the doctors with their coding practices. Which seems to go in one ear and out the other one. They are not being held accountable for the coding that they are doing or not doing. Some doctors aren't even working enough to help bring in revenue. Because they get a big salary and could care less how many patients they see. Which is cutting into our bottom line. And the coding department is always the ones to blame when revenue isn't being generated fast enough. To keep the money coming in. Right now our coding department is under a huge strain work wise. We have lost 6 people in our department. 2 coders that were very much needed. And being threatened with being outsourced again. Which hasn't proven to work any of the times it has been partially tried with some doctors.     Otherwise, I love my coding job. But may have to seek employment else where in the future.

I expected to be promoted to a coding position upon passing the CPC exam in July of 2007. I still do clerical work 1.5 years later. 

There are several different coding departments that divide duties. This has resulted in gaps where services are not coded therefore not billed. Everything is coded by physicians, we know they are not accurate, but not everything is reviewed by coders.

When the coders go to classes and return with information, the providers do not always accept what we have learned as accurate

I work for a hospital physician billing group.  To my knowledge, there are only two certified coders. I am one of them and work in a specific office.  The other certified coder works in the CBO.  Certification is not encouraged by my employer, however, they always call me for my "expertise."  There is no required annual education on documentation and coding for the physicians by our employer.  I think this should be part of their CEU requirements.

Our office presently has no administrator or supervisor at our site & we are owned and operated by a hospital 35 miles away in a different time zone.  I feel the billing staff is hanging out on a limb and no one to turn to for advice.  When we need answers it might be days be anyone responds to our calls or e-mails.

I work in a very hostile working environment. I am hoping to get another coding job where they pay me what I am worth. Since I have a college education, I am discriminated against very much.

Employer should offer better books to do the coder job and should offer more time per case to better review each charge correctly.

Working for a for-profit hospital does not offer the same encouragement and efforts that teaching and not for profit hospitals do. Our physicians do not have the same congenial approach that a teaching physician does and often is not as involved in the community as others are. Thanks.

I was hired as a surgical coder and do way too much more than I was told. I cover for the medical staff and am expected to do my job even with all the unnecessary interruptions. I think I'll be better off as a consultant in the near future.

I don't think my doctors or too many other doctors understand the importance of  coding.  They see it as my job to fill in the blanks or to correct their coding  to get the bills paid not necessarily to code it correctly.  Think proper coding is an area that the new physicians are coming into practices knowing something about but educating older physicians is still a CHALLENGE.

No developed career path for coders; coders are under-utilized and not involved in many corporate activities

My employers do not recognize the CPC certification as  a valuable certification.  They feel because there is not  an associate degree attached, it is not valuable.  There are  four of us working here that were grandfathered in so they feel they are stuck with us.  They do not understand what it  took to get our certification, because none of management took our exam.  They do not let us code outpatient surgery charts.  We are only allowed to code pain centers, ERs and lab reports.  They even created a lower pay scale for CPC coders than other  coders that work in our hospital.  I guess what I wanted to  know is, Are there other CPC coders that have this problem?

My current work environment is a "coding mill" for an extremely large ER Physician Group on the East coast with multiple hospital sites.  Although we have Policy & Procedures, on site management is more interested in production numbers than accuracy.  Yes, we have a QA process but management will constantly switch the hospitals that coders are familiar with and have established accuracy and efficiency in order to sabotage the coders efforts.  It is a no win situation and surely an embarrassment to the profession.    When the Coding Manager was asked about company reimbursement for CEUs, CPC Test, etc. her reply was that "it doesn't have anything to do with what we do here"!

I wish I could focus solely on the coding and not on other office clerical duties. I feel that the doctors don't always listen when I try to help them improve their understanding of e/m coding.

Code for two orthopedic surgeons ICD-9-CM, CPT, some HCPCS through CODE X software. The office is going to EMR and therefore, my job is being phased out.

I work at a VA Hospital for a contract company. My work consist of reading the encounter and deciding if it is first billable according to their guidelines. Emphasis is on quantity and then quality. I have had very little training in an atmosphere best described as a sweatshop. My every move is scutinized (i.e., bathroom breaks, no deviation from schedule without a 24-hour notice, no paid breaks). Overtime is the norm not the exception. I have experienced more negativity for my work than praise even after working 60-hour weeks. There is absolutely no respect. This is the third contract company I have worked for and I all but have come to the conclusion to leave this profession.

I am not currently happy with my work environment, but it is the only position I could find that would allow me to work from home and continue my education. My manager is not certified, and often pits one coder against another to cover for her own incompetence.  I provide feedback for my physicians and never hear back from them.  My manager is not interested in hearing about compliance concerns.  A lot of the documentation I receive is incomplete and illegible and my manager is unwilling to send it back to the physician because it would delay money coming in. I am not provided with all of my books, nor software that I need to do my job.  My company does not assist with my dues or financing CEU opportunities. I really wish this company would realize how valuable my services are and use my knowledge to further the success of the entire company.

No one acts like credentials seem to matter. Sometimes people are asked to code when they have never had any experience in doing so.

Most of the coders I work with are noncredentialed.  This is the first time I have worked with noncredentialed coders and it really makes a difference.  My manager does not have a coding background which makes my auditing duties more difficult.  I may change jobs because of the above 2 reasons.

It doesn't matter if it's right, only that you are PRODUCING!  When I have to follow up on another coder's work and change the codes to what I KNOW to be complete and accurate, I get dunned for having too many DRG changes after discharge!

I was originally hired to train as a vascular surgery coder, but after hiring & before leaving the other company to come on board, the company changed how it did things & the job I was hired for disappeared. Eventually I was billing  for several doctors which requires some dx coding & checking the doctors' CPT codes for accuracy & applying modifiers as needed. But I really don't do all that much coding. The job was NOT what was promised.

Unfortunately providers are mandated to use a specific program that does not accurately reflect the CPT, and ICD-9 data. Many times for one ICD-9 the program that is used, will have 63 different definitions for a diagnosis. There are also times that the system has the incorrect definition listed for a diagnosis code. Usually, their system will downcode all of the providers' E&M .

I feel I spend a lot of time filling out spreadsheets to identify what I did that day, I find it time-consuming. Physician education is a must. I have physicians who are very resistant to change and need to have updated education on what is necessary in documentation and compliance.

The coders have little say about daily assignments.  This is handled piecemeal and leads to frustration.

I work in non-hospital based radiology practice.  My manager feels that the only workshops I need to attend are those related to radiology.  Therefore, I have to arrange to attend workshops or meetings on my time off, which sometimes means changing time off during the week ( I am now working four days/week).  And, of course, fees and dues are my responsibility.

I work with several certified coders and data entry people.  The providers are off site and receive coding guidelines from the auditors within our organization.  I find that the providors do not code  well  even with the classes given them.  I am constantly calling and asking for more documentation and/or recoding to the documentation I have.

My employement does not recognize CPC as an essential in their offices. They do not give us the materials that are needed to do our jobs. The billing is done from a central location and they have billing people in offices doing nothing but entering charges and they do not supply any training for the CPC to do their jobs effectively. I am looking for another employment to use my CPC skills and to learn and grow.

Too much time searching for information in order to be compliant  with work of coding outpatient cases and at the same time they required accuracy and productivity .When audit comes the percent is too low. I am personaly in disagreement with the method  and scale to measured  performance.

Small number of staff expected to do large volume of work. Management has no  respect for coders and have used receptionists to code at times transferring them from reception to coding/billing with no experience claiming, "Anybody can do this; it's an open book test."  Did not bother to replace coding manager or insurance adjudication manager upon becoming director of billing services.  Very serious lack of communication facility-wide.

This is an old practice group that is not in touch with the 21st century in many areas besides coding and reimbursement. The CEO hasn't a clue what the real world is like.

My current work environment leaves a lot to be desired. I have worked in this office for over ten years and have asked so many times for help on becoming certified because I am not comfortable in a lot of areas. I am told that certification is not necessary and I was shoved into this position with absolutely no training. The office manager (i.e. owner) isn't certified either and I have found many mistakes on her part.  What I've learned these past years I taught myself. I am seriously thinking about taking classes and getting certified on my own.

Underpaid. A lot of research and studying is done from home. No time at work to research coding questions

My boss is horrible

My work environment is most unpleasant as we have several employees that goof off, talk constantly and rarely work. Management doesn't notice or doesn't care. 

I feel like coding is a very serious and detailed job, but we are responsible for so many providers and have 100% abstraction that I feel like my coding isn't as strong as it should be.  Rather, I am becoming a paper pusher.

My employer cares more about quantity over quality.

We have an EHR with the codes built in, these are extremely inaccurate and the verbiage is often incorrect.  The providers must use the codes and verbiage in the system and coders must correct the codes. The providers don't actually us cheat sheets or picklist with this system.

I wish that there was somewhere or someone to ask regarding coding question specific to our practice.  For instance, if the coder and the physician are in disagreement on how to code a px, we are required to show black and white proof of our arguement to the dr before they will allow us to change the way they are coding.

Too much emphasis is put on reimbursement. We need to be staffed appropriately for the volume of patients and ensure that the documentation supports a good claim. Our issue is not enough documentation and not enough provider education programs.

Love coding and working in the office. Sometimes, I need a little more to keep motivated. Too much other stuff to get done. 

It would be less noisy to work in the office setting currently in and work from home. Having had the opportunity to do this before our office policy changed, it makes productivity higher in some cases. Without the noise I was able to read through the operative reports, properly select the codes and sequence both the ICD-9 as well as the procedure codes. With interuptions in the office, it can be difficult to work. We even tried using signs to indicate when someone needed quiet, but that was ineffective at best.

I am single and have a special needs adult living with me. I paid for the CPC exam out of my pocket for December 2007. So I am recently certified. To obtain CEUs I will have to pay for these out of pocket also which can be very expensive.     My job is 100% CPT coding. I have not been shown anything else. I've worked in this capacity for about 7 years. I was certified as an ART (now RHIT) in the 1970s. Why lapsed? I had 2 young children and no support from my husband (now ex) at the time. No family either. 

Our practice is multi-specialty.   Only a handful of doctors would know coding staff faces in a line-up.  We work in a basement with hand-built cubicles  as our work spaces.  Our nearby co-workers are Medicare and Medicaid Review Specialists and posting clerks.  As well as coding for multiple physicians, we are required to answer an incoming physician referral telephone line.  All of these calls are simply transferred to another location in the practice.  We are simply instructed to answer them promptly and send them on their way.  It can be quite difficult to code something specific that requires intense thought when you are interrupted to simply transfer a phone call.    I am exhausted, have back, neck, and shoulder pain from my non-ergonomic working conditions, constantly interrupted by the incessant ringing of a telephone, rushed, stressed, and have not even been approached by management about a pay raise.  I am angry, disappointed, and daily wondering why I have stayed at this job for the last six weeks.

Our work environment is very stressful, our employer seems to put more value on productivity rather than accuracy.

I work for a large city based hospital in the central billing office for a hospital based practice (womens OB/GYN clinic).  The front end billing is done by the front desk staff (no coding training, lowest pay scale)leaving a huge mess to clean up in my area (back end billing) with many coding errors, denials and lack of documentation.  This seems backward to me as I have been coding for many years and believe strongly in accuracy at the front end first.  Send a clean claim and get paid the first time!  I am not hired as a coder but as a biller but I must use my CPC knowledge to complete my job and I am not paid for that certification.  I have been an educator, coder, biller for many years.    Please, please offer more training to the hospitals in teleconferencing for billers/coders that can be done on a lunch and learn basis or something similar.  This needs to be marketing strongly.  My employers in the past have always supported my education and I find that isn't true when you are hired as a "biller".  We are doing the work but don't have the support and must do it on our own. 

Coding would be much more accurate and faster if the providers would attend formal training on coding and documentation.

not enough hours in the day

Most employers still do not really know that much about certified coders, they just know that they need them. For what I do (risk adjustment) it is required by CMS. My company hired a CPC-A and didn't know the difference. My company (and I think many) think that if you are certified you can code anything and that all certified coders are created equal.  My company hired a CCS and is paying her less than everyone else.  My company has certified coders doing abstract coding of hospitalist inpatient notes and they call them billers!  It is very scary what some inexperienced coders are coding.  Also, I have found that certified codes are not very knowledgeable regarding ICD-9. When we interview coders we give them a simple test and no one has done very well which means I have to train them on basic ICD-9 coding. (The worst is no one knows that you need two codes for a manifestation due to diabetes) And forget documentation guidelines. Everyone is clueless.

I was hired as a Contract Analysis Specialist, entering and reviewing contracts for reimbursement and billing inconsistencies. Although I have been certified since 2003, I was never given a coding position or opportunity to shadow, denied even by academy members.  However, knowing of my CPC, I am constantly engaged for coding assignments; relied upon to answer questions and instruct the practices on coding issues (Who are not staffed with certified coders).  I often feel stressed to provide the most accurate information, yet exploited because I am not reimbursed for my certificate. I am even contemplating removing CPC from my resume altogether.  Thank you for the reference websites, though my company's firewall blocks many as "job seeking", there are many I am able to access and utilize to provide valuable information.  Despite all things I strive to convey the best coding practices for optimal reimbursement and compliance as an asset to team and practices we serve.

I love coding and I am the only certified CPC. But I am in jeopardy of losing my job to a coding service where the coding is done from India. The last six  years my certification has cost a lot of money personally to keep up but  professionally has not benefit me over non-coding personal.

The coders work the front office along with coding so it is very difficult to find the time to code.

I work for a hospital-based practice and my CPC standing is not acknowleged. They do not use me as a coder.  There is supposed to be a reimbursemant policy for which they denied any payment to me.  Another person in this office did the same classes, the same teacher and all of her supplies and classes were paid for.  The cost of taking the test was paid for.  I paid for my own. Therefore I keep my eyes and ears open for better opportunities.

The hospital I work at signed me up to take the CPCc.  it was the wrong degree.  When they found out it was to late and I had to go through everything. I am commited to the hospital until June.  Therefore I am not utilizing my CPC.   am a coding associate at the hospital. I code one times which are people that walk in for lab and medical imaging things. I just code the icd-9 codes and do a lot of data entry.  I cannot answer these questions.  i would like to find a part time job working in a office.  No luck yet.  My bosses what me to go for the CCS exam.

My company has decided to outsource coding to another country. Due to the changes the company has made,  people are losing their jobs and not doing the job they have worked so hard to maintain and have lost the pride they used to have in their work and the company they work for.

The providers do not understand the importance of coding and documentaton requirements.

There is little to no training for providers. When do they have time? They learn by us dinging them. This makes them feel we take away their funding. If the providers are going to expected to code then it should be taught in med school.

I currently don't work in the medical coding field. I completed certification requirements and have attended a mastering Medicare seminar along with maintaining my continuing education.  I contacted the local AAPC chapter secretary about joining and never heard back from her.

I am the only coder in the practice. I find that the older doctors are not receptive at all to coding issues.

I check doctors coding and correct it as necessary. Add modifiers, figure assists codes. send in document corrections to facilites. I bill all surgeries and some daily office charges. My work environment is not pleasent. Even with getting certified I don't get much respect from the doctors or assists. Coders rank low on the food chain where I work.

I currently work in a medical multi-speciality clinic that does not  have a coding dept.  All nurses code for their own Drs. for in office and hospital charges.  I feel that if they would come on board with a fully staffed coding dept that the revenue lost from inexperienced coding would make working there a much more enjoyable experience and also allow for updating of our very outdated systems that we work with.  Our  overall loss of money is  out of sight

All physicians should be required to take coding classes before they graduate.

Work hours need to be flexible to allow for more "quiet" time in performing the coding responsibilities.

Coders are not given the time of day by physicians and we are underpaid for our knowledge. 

I feel that where I work, the importance of the coder is not recognized for the value they have in bringing in revenue.

It is very sad that at my job my work is not recognized. Managers many times don't even know what  a CPC coder is. Until we let them know that we are the revenue providers in the company.

I feel as though my company lacks the knowledge of how important credentialing is and that they don't feel as though I am as important as the licensed techs we have in the facility. However, my job is equally as important, if not more. 

The focus of my job is to review claims that are kicked out by our claims scrubber on the front end.  I conduct annual physicain audits with feedback and education.  I get involved with the difficult appeals.  I am the coding resourse for a 100+ physician group.  I feel that I am spread too thin at times.

I am the only certified coder in the practice & the only coder.  Due to the implemtation of EMR I do more data entry than when not using EMR.  The only reason that I handle the claims filing processes is because of my knowledge of computer systems.  I also have a BS Degree & feel with my CPC I have an advantage to be employed in any state.  In the next few months our practice will be adding at least another physician & possibly more later in the year.  Our practice also employs an ARNP.  This is a family practice speciality & as a certified coder due to this specialty I don't get paid as much or have as many benefits as coders due in surgical fields but as a coder I think we see more unusal coding scenarios than surgical coders & don't get the same respect or pay.

In the family practice that I work in, the owner/provider also has a pain care practice.  Among the dozen billers that I work with I am the only one certified and all of the other billers have no interest in becoming certified.  This boggles my mind. I am told that they see billing as a job and not a career.  The owner/provider will not hire certified coders but he will give you the training to become certified on your own.  Does that make any sense?

The most frustrating part of performing my assigned duties is dealing with Medicaid, Peach State and Well Care (All Medicaid programs in Georgia) and United Health Care (Georgia's coverage for state employees) and PPO networks (to a lesser degree) and their ability to disregard common coding practices and make up their own rules as they go. Also, dealing with an unreliable software company that does not seem to understand coding and the importance of accuracy, compliance and timeliness.

Drs. do not believe the coders when they tell them what the limits/requirements are. We have even brought in speakers from the Medical Soc. of VA who are also certified coders to explain the liability they take when they insist on using codes we know are not correct but they don't believe the speaker either because they think they are always correct. Coders play the roll of "code police" and try to correct claims before they can leave the office, but do it discretely. We constantly worry about audits.

Because I work for a large corporation who employs 100's of physicians I only answered for the few I am personally responsible for.  Physicians should be required to take coding and  compliance as part of their medical training.  My physicians are not receptive to my recommendations when it comes to documentation.  They percieve it as me telling them how to do their job.  Fortunatly, I have the backing of my company, unfortunately they still don't do what needs to be done to get paid.

I work for a medical billing company who is in the process of streamlining the different departments into teams - charge team, payment team and AR team - I personllay have done Urgent Care billing for the past 5 years and now am expected to know pediatrics, surgeries, hospital, etc billing.  I know change and increased knowledge is good, but this was tried once before and it failed.  Not enough training on the specialties or the right amount of time to learn.

I love my job, but am often caught in the middle with compliance/finance and my physicians.

I am the only certified coder in this practice.  But the office is far behind in technology.  I purchase my own coding books and have to pull all updated information on Medicare and other insurances coding policies on my computer at home.  This office is not internet ready.  I want to do so much more but the office manger does not like change

I am often asked to perform front desk duties which takes away from time needed to verify codes from doctors and comply with CCI and CMS regulations.

Sometimes it is very hard to keep your intergrity intact when your manager/management wants numbers and not quality.

Coders are considered part of CE and their say is not valued many a times. We are under the pressure to code the way client tells us to do.  

My comment is that even with the information provided on the importance of accurate coding, some providers feel they are being asked too much when asked to document and/or code properly.  Another sore point is that some of them feel that coders and others involved in compliance are trying to tell them how to do their jobs.

Physicians pay for what they get. They are not willing to pay for education or experience when it comes to coding, billing or compliance.

I live in an area where the hospital and the doctors do not give any respect to their coding staff.  They are looked at as a nuisance they have to tolerate to get their reimbursement.  They do not believe they will ever be audited.  I made it very clear that I would not under any circumstances code for money.  I have educated myself using CRN online, I pay to use Code Correct out of my pocket, pay for my own dues, and pay for my own supplies other than the ICD9 or CPT. I am not sure if I will take the board as it will at my own expense and due to the area it will not make any impact on my salary.

I work at a military treatment facility, which is different... The doctors use EHR software with the coding component.  Mandated by the pPresident in 2003. The problem - it is not accurate.  My job is to audit what the doctors do.  Because of budget cuts the coding staff, which I was supervising, was not replaced as they retired etc. leaving me to manage the auditing, educating, task meeting, report providing, etc. So a small percentage of what they "code" actually gets looked at.  We have approx. 30 doctors.  I make sure that the encounters attached to third party insurance are audited 100%.  The Surgeon Generals Office provides 2 monthly Coding Video Teleconferences.  I was allowed to attend an AAPC Conference in 2004.  I sent an employee in 2005 but again budget cuts prevented my going again.  I still put my request in every year.  I teach  coding and reimbursement classes (schedule 4 per year) which is where I get the majority of my CEUs.  Thanks.

I have 7 surgeons (3 specialties).  There is just me & 1 part-time/casual coder. Both are certified.  I do all the coding/billing/claim submission/payment posting, reviews, patient collection and end of month finance reporting.  I have four of the 7 surgeons coding their E&M - of which only about 50% is accurate.  I have 1 surgeon coding his surgery & constantly unbundles, irregardless of training/compliance.  Otherwise, everything is left up to the business office.  I am overworked/underpaid.  However, due to healthcare environment, I cannot find work for what I am being paid (salaried/managment).  In addition, I support our 3 sites with registration/insurance entry questions.

I work with Electronical Health Records. They provider choose most everything and I review only the ones that seem odd. I only look at notes occasionally if needed. The providers don't like to think they made an error. Some providers feel extremely threatened! Most don't appreciate the work or help we have to offer them.

Our physician network now emphasizes compliance in E/M coding and sends charts for audit every week. The results are then sent back to each provider.  But our physicians have not had hands-on CPT and ICD-9 coding. Just a presentation every couple of years on E/M documentation. They feel like they're still struggling to learn it. Our physicians would also benefit from an in depth ICD-9 presentation which would make our diagnosis coding much more accurate.

Respect is the most important and that is seriously missing.

Coders are still not paid what they are worth and a lot of the positions in a physician's office are grouped under management and not recognized still.

Not given enough time to do all the work expected of a coder.

I have been doing billing for almost 8 yrs now with physician offices that are privately runn and currently work in a smaller practice with 5 physicians where I have been doing billing now over 3 yrs now.  Never has there been a biller/coder to be certified working in the office. I just currently became certified as a CPC and am the 1st in my office to be certified.  I work for a pediatric department and they will not increase my pay by much and have told me they can't pay me what I can make somewhere else as a CPC.  This is so discouraging knowing my ablities to the office and how much hard work I put into the coding and billing.  I even follow up on claims to get them paid for the physicians.  Other billers we use are people in the office we have trained and people they have hired in that have no billing experience.

Front desk checkout needs coding training.  Physicians need to understand the significance of correct coding.  They need to realize they can not always get paid for every individual item they perform; that sometimes their notes do not support an additional procedure being paid.  If they can't convince me, how can I convince someone else?

Unfortunately we have a clinic administrator who suffers from ADHD and doesn't  listen well to execute things brought to her attention. She  misses major contributions by employees.

My employer does not take an interest in what I am coding or me.  The administrative assistant (my Boss) only takes an interest when I approach her with a problem or question.

I work for a Medicare Advantage plan with current membership of 10,000 plus, so questions regarding "practice" situations, don't apply to me.    My company also has commercial insurance plans, however, I am the only claims person /coder for our Medicare product.  We outsource our processing, so my "co-worker" is only available through email & phone.     My tasks are provider appeals, claims auditing, investigation of claim issues  for resolution to correct payment, tracking of claim issues, investigation of compliance issues to determine if there was a HIPAA violation.   I also research Medicare coverage of various procedures and services to answer questions from other departments, such as customer service and pharmacy.    That together with too many meetings - I need a clone.

Physicians in my practice need to allow practice manager and certified coders time to get their jobs done instead of having them perform so many other job responsibilities that they get burnt out trying to get the work done at home after hours.  This causes errors to happen, dissatisfaction with their job and ultimately the 'I just can get it done' attitude which affects the quality productivity.

Many physicians coming out of medical school have not been taught how to code, let alone how to document.  This needs to be done in Medical School before they get out and start their practice.

One physician was extremely argumentative and did not want to hear what "doesn't make sense" to him regardless of rules and regulations. Another was simply not focused enough to treat patients as well as code correctly. There was constant review of documentation b/c of these issues and I am now no longer employed w/ this practice.

Currently without a coding/compliance supervisor--recruitment going on now.  Answers above are influenced by this fact.  Billing volume is emphasized more than is correctness, unfortunately.   Coders' education, intelligence, and emphasis on accuracy/compliance is not appreciated as much as it could be.

The head doctor has a problem with ordering many unncessary tests on patients. He fails to understand that the medical necessity revolves around the dx/symptoms of each patient. Since he is opposed and watches the habits of the remaining physicians in the practice, it is very hard to explain to all the doctors why you need to watch this, when the head guy is cracking the whip.

It is sad that they want a CPC to be a follow up person and handle phones also. They want to incorporate our talent into low paying jobs and still protect their behinds in problems and audits.

I've been certified for almost three years, the only jobs I could get were what the locals called "back end coding", I did workers comp where they quite often told me that they did not need and would not pay for a coder.  I transferred to a central billing office for 24 plus clinics where I was a billing rep responsible for refiling denials.  I didn't use my coding in that position.  I then transferred to a position that I did get to use my coding skills as a compliance specialist.  My husband transferred to Idaho, but since we moved, I have not been able to get a job either in the coding field or in the billing area.  It's not lack of experience, I've been in the medical field for over 20 years, in medical records.  I even managed a medical records department for three years.  I worked in medical billing/coding for almost four years.   At this time, I'm on the verge of leaving the coding behind as I've been offered a job with the tax dept. .  It's difficult to collect CEUs, sometimes expensive.  I just think it's a shame that someone who is willing to certify, to take the classes, then the test, to maintain their certification, etc, that someone cannot find a job as a coder.    When you do your salary estimates for each region, do you factor in those of us who have struggled to get into the coding field and can't get a job as a coder?  I think it would bring the salary average way down but it would be more realistic.      I know I'm not the only one in this situation.  My co-worker in my old job who actually had five years clinic coding experience recently had to take a job in a position that doesn't recognize or require her coding certificate or expertise.  Thank you for letting me vent a little..... 

I need to move on...

My responses are odd because I am it........We are a solo practice in a somewhat rural area, I am the only full time employee, my job covers everything from vacuuming the office & feeding the fish to all coding, billing, and reimbursement analyst........I also fill in when one of our two part time staff are not here (reception & assist phys).  In my past life I was a compliance analyst at a large teaching hospital but made the big leap and moved 5,000 miles away.  I am doing a little consulting, but the regular job takes a lot of hours.  There seems to be very little knowledge here regarding coding/billing; a number of "will train" by the physician and family members working in the office..............But it is sunny and warm here.

Work environment is very caustic and I am searching for a new position. Work loads are extreme due to the huge atrition rate at this company.

My workplace has little support for its coders and the job that we have to do.  The providers and hospital want us here to increase reimbursement, but will not listen or open up to education when given to them.

I enjoy my work but not always where I work.  If the coders in my practice were not put on so many extra projects, we would have time to complete the coding.

I am the only CPC in the office and I do not do coding.  I do follow up on denials.  The people that do the coding are not certified and accuracy is an issue sometimes.

At times my employers make me feel they too interested in meeting a quota and we do not have enough time for accuracy.

Coders are viewed as important but not as important as the billers. They want us to code 70 charts per day and BE ACCURATE! Find they value us less and less each year. I also can't understand why they won't pay for us keeping our credentials???? 

I work for a Pediatrics facility and all E/M codes and ICD-9 codes are picked from a cheat sheet.  The physicians don't automatically send office notes over, so we have to request them a lot.  When they are sent over most of the time there is hardly anything written down, and the sheets aren't always signed so we have to send them back to the physician to sign.  My office manager has tried to stress that in order to get better reimbursement the physicians need to document more, but they say they are too busy.

I work in an Army Hospital. The providers do not want to code and they do not care if they code wrong. We provide feed back to them to help them understand the requirements for coding accuracy but they do not use it. Some of the providers are contract providers so they feel they get paid one way or the other. The providers that are in the Army are just as bad. It makes me wonder how they keep their rank.

I work in a specialist office the providers are good with procedures but for office visits (E&M) they don't understand the inportance of good documentation

I am sometimes torn by what my administrator expects me to do when I disagree with her ethically. I do not feel as the person responsible for all the ICD-9-CM coding and some CPT coding for a large practice that my skills are as respected as they should be. 

The coding I do is too much for one coder. The work enviroment where I work is way too noisy and too busy to have a desk in the middle of flow area,. Customers are in and out. No privacy or quite to really coincentrate on your work and coding. The pay is very low for some one who is certified. My wage is based on a chart average. If I was some where else I'd be getting paid more for all what I do and have a quite place to do my job.

I work very hard to be complient and to code properly. I find most providers don't care. They want to do things their way. But when they are denied it's the coder or the manager that is at fault. Doctors won't listen to anything we say. But when they get audited it's the manager or the coder that didn't inform them which is not the case. There is very little respect for coders or office manangers that are CPC. The doctor is always right. It is very hard for a provider to accept change when it comes to billing and coding.

I am the only coder in an office of 12 physicians and 2 PAs, between two offices, with specialties in Urology, Fertility, and GYN associated to Urology. I am expected to code and or verify all surgical procedures via op report for approximately 100 surgical tickets (ranging from 1 procedure to 10 procedures per ticket)( About seventy percent of doctor-coded procedures have a coding problem) I am also responsible for responding to all coding related denials for 7 billers with an average of 3 per biller, I am responsible for checking all coding errors on, approximately, 250 office tickets. Not to mention about a dozen other responsibilities. My manager is not a coder and I am their first certified coder and feel that their expectations are extreme and have caused me to develop an ulcer, literally. I am given a 3 day turn around for all surgeries and to the end of day for office tickets and 2 days to return billers questions. If there is ONE mistake I am warned via email, verbally, and with a degrading hand written note. I am expected to have a 1-2% error rate. I have been told that because they have no data at hand showing that a higher error rate is acceptable and that is why they "Just chose this one." I wish someone would write an article on how much work is enough and how much is RIDICULOUS!!! Also to include acceptable error rates (very tricky) with which errors should be considered unacceptable and those that are tolerable/ workable/ improvable. Please include how much work one coder can be expected to complete in 40 hours. How many doctors should one coder have? Depends on specialty, how many surgeries they perform, the complexity, the doctors ability (or lack of) to document in a manner that makes your life easy or very difficult, how many specialties are you switching between each day, do you have to hunt down the op reports yourself (I do), do you have to pressure the doctors to dictate or make addendums, do you have to explain every coding decision to your office manager (who is not a coder)? I could go on and on...but won't. I hope that someone writes an article about the above...

Most managers do not understand anything about coding and are not certified.

I wish we were appreciated for what we do.

I feel that my office need more space so we can hire more coders. Not enough coders.

work environment extremely noisy, not a very good work area

I currently do accounts receivable. The work environment is one that people are not very happy. 

I work as a coder for a lot of physicians.  I coded for the Hospitalists (13)physicians/PAs and did all their coding/charging/registering and anything else like getting the insurance and pre auth numbers that were needed. I was the only person doing this for this many physicians.  But according to my facility I am not in a coding position. Then the took me off the hospitalists and put me coding the operative reports for the physician services. This includes but is not limited to cardiothoracic/ortho/ortho /locums/general surgery/and plastics.  (This they also consider a non coding position). They put me in this position because I was the only coder they have to code these reports and because I am a detail-oriented person.  They supply the coding books for us, but they don't have the CPT Assistant or other materials that would be useful. They are using an Alpha II system that hasn't been updated for 2008.   I'm told to code from whatever documentation that is available that has the name of the procedure on it.

There are often wonderful coding workshops held by various medical societies and by AAPC.  Because of the cost associated with these (including travel, hotel) many providers shun sending coding staff.  However, the providers (both physicians and nurses) freely attend seminars to obtain CMEs.  It seems as though there is a double standard in the industry.  It can be very disappointing.

As a coder I work for almost 40 anesthesiologists.  I am working on becoming certified. I have been working for this company for almost 6 yrs. my job responsibilities include getting demographic and insurance info from the surgeon who performs the surgery, coding from the op report, and verifing that the procedure performed is the procedure that was circled by our doctors. and that everything our doctors have done that is payable is being submitted for payment.i also do the insurance runs paper and electronic and deal with any issues that reject or pend from the electronic billing. I have been training 2 other coders for this job to help me and I also audit there work. There are also phones to answer and filing to do. The enviroment is not the environment preferred by a coder.

As a department we feel that the physicians and administration dos not recognize or appreciate the work we do.  We believe that we are overlooked as somewhat not necessary.  We think it would be nice for them to understand what we do, what we can do, and how this benefits them.  We just can't seem to get them to pay notice.

Being a certified coder, I have a tremendous work load, my supervisor doesn't understand my job to the fullest and consequently denies my request to work overtime just to catch up with coding, while she expects our coding to be up to date within a day of visit. Supervisors need to appreciate their certified coders.

This is certainly not a good work environment in that the work that is done is not appreciated, it is considered a pain and a waste of time by the physicians.  They do not give appropriate consideration or appreciation to the important tasks of coding and compliance.  They ignore the risks of incorrect coding.  They do not appreciate the loss of revenue from missing charges and undercoding.  In general, this is just not taken seriously and it is difficult to get their attention and move forward.

Our physicians generally undercode except for a couple. They ask a lot of questions but don't really have a good grasp of coding.  I give them as much education as possible but they still fall into the same bad habits.  We don't have a coding program in place but I wish we did.  I am the office manager and a coder so it's a huge responsibilty.

Physicians in all sectors need far more education in coding then they receive in med school and residency programs.  Physicians are ill-prepared to come to the office ready to code, and many resent someone "not at their level of clinical expertise" telling them how to code.

Coders are not recognized as a crucial part of doing business and I think that every job is an important part of the overall business.  I code from the denial aspect and I pay for my own CEUs and it is not even recognized but is expected

We share an office with receptionist, clerks, coders, specialist, copy service and transcriptionist. It can get quite noisy and distractiong at times. It would be nice to have a quiet environment to concentrate on coding and to not have interuptions from customers and fellow employees requesting charts, information and other stuff.

I work in a family practice and I am the only certified coder. I work in follow-up and denials. I was advised that being certified coder was not requirement for the job in  our billing department.

Most physicians are wanting to be more involved in coding or at least doing it correctly. They however are not always willing to change.  Most smaller offices I work with are doing only what absolutely has to be done to manage or stay afloat.  Many want coders but their people are coders/billers, patient account reps, check in and check out personnel all in one.

I work for a small acute care facility that has 24 beds.  I am the only coder in the facility.....I am certified with my CPC-H and my CCS.  I currently code, inpatients, observations, surgicals, outpatients and all ER's.  I also set and input e/m levels and all emergency room charges.  I read all operative reports and input their surgical procedure charge.  I do all observations IV charges, pushes, infusions, etc.  I also am in charge of, along with my supervisor, the chargemaster.  I keep the limited coverage table updated.  I also do all the birth certificates in our facility.  I also do montly physician QA and monthly statisticals.  I also now have to do the monthly reports to the department of labor in regards to our monthly charges.  I was also given our policy and procedure manual to update and revise.  Along with all of this I still help in our medical records department as needed, answering phone and faxing requested reports.  This is an enormous amount of work and I know sometimes my coding suffers due to excessive extra duties.  I like my job but enough is enough.  My fellow coworkers are great but none of them do what I do.

The whole coding staff is pretty new to coding and to this office and it is my understanding that coders are not to code the E/M codes and we are only allowed to "correct" the ICD-9 codes. Otherwise, if we disagree with the CPT codes, we are to send a formal inquiry for the provider to correct the CPT code. Also, I would never presume to judge the amount of education the providers have had in coding and would not ever check anything that might reflect negative against my providers.

I can't seem to get my physicians to truly understand how important it is to be certified, registered.  They only look for coders who have been doing such for many years.

I do Emergency dept. billing. I read all of the charts and determine the E.D. Level and other charges incurred such as IVs, lacerations etc.    My title is Unit Tech. because that's what I did for years and if they call me a coder they would have to increase my salary.

Currently where I am employed, there is an abundance of change that needs to take place. My employer doesn't want to pay the salary for a "certified" coder instead they like to overload the worker that is certified and make excuses on why they are unable to increase their pay. They also play a lot of favoritism and in my opinion it really lowers the morale of the company.

I work in cardiology and we are responsible for coding all office e/m and hospital e/m and procedures.  we do not code our coumadin, pacemaker, nuclear, diagnostics, or echos. It is a concern that i don't see these superbills come across my desk.

The only coding that I do is ICD-9 I think that there should be a test just for ICD-9 coding and with the exam that is done now. I think that you should only have to retake what you did not pass. I have not done any CPT coding since college. That was back in 2003. I do not do any coding for that and I think it is unfair to make someone retake a test when they are only week in certain area's. If that was the case I would have passed my exam. I do a good job at ICD-9 coding and that is the only coding that I will do.

Never enough time to do it all or read everything I need to read. 

We do a lot of research for proper coding and chasing providers on the same day of service because they lack proper documentation.

Any coding position should not be done at the front desk in the office.  You should have your own office to manage your time efficently and not erratically.

High expectations for one coder to do multi-specialty practice coding for all providers. Need more support from management. 

I have been doing medical billing for over 20 years and I have a hard time with  testing. The problem is that I  will be put in another position  because I cannot pass the test. So all my experince in surgeries and E/M has been  a waste, because the physicans do their own coding. The people that have passed  do not understand the coding and have a certificate that they really do not  use or understand.

I enjoy my job here but I do wish we had a better working relationship with the doctors.  It would be nicer if they were more approachable and I am just not sure how to accomplish that other than just keep on trying.

The above survey is based on a position I held for the last two months, but just left.  The position was medical records director for a long-term health facility; however, I left because the I was being asked to compromise professional ethics in order for the facility to operate substandard.

A great deal of emphasis is placed on productivity rather than the quality of coding.

There is not enough time in a day

Coders should code, period. Related billing issues should be handled as a team  with billing personnel and management.  Coding is too technical and time-consuming to expect coders to handle anything else, even though they may learn a lot about it in the teamwork process and thus become more valuable coders.

I believe with my qualifications I should make more than the 10.97/hr I make. Do you think maybe 18.50/hr would be the right aound? I've been coding since 1987. Are tehre jobs online or that you know of that may benefit me in some way? Thanks.

I'm frustrated with providers trying to code based on what will be paid rather than on what services were provided.

It would be nice if Management would spend more time teaching & educating coders to code in excellence. Intead they are more concerned with employees being certified within 18 months of hire. Just because a person is certified, does not make that a good/excellent coder. It's up tp management to find out a person's strenght & weakness give that individual training, classes, seimars before kicking them to the curb. It's not good for management to make threats of putting employees in corrective action for not being certified.   My last comment is, AAPC should allow a person to re-take the  Exam in the areas they have missed only.  In February will be my 4th time taking the exam.  My frustration is failing in the areas where i'd previously passed.

Our providers use a documentation/coding program called AHLTA which is not user friendly and is set up for coders not clinicians. A different documentation system would be much more accurate and appropriate for our hospital.

Although I have repeatedly tried to educate my physicians as a group, I have found that the only one's who tend to be receptive are the newer docs to the practice.  The docs don't mind if I correct their coding (by auditing the visit) but they don't generally want to know about it or why it was changed.  Several of my docs seem to spin a wheel to arrive at a code, while others only charge one level at all times.  Very frustrating!

I code for multiple providers. Some of them are relaxed and understanding, but many of them expect to be notified when their own coding or their documentation is not sufficient, and then are confrontational, or rude about the notifications, even verbally defensive or combative at times. I work in a room with multiple coder and we share the experiences we have with the providers. As a whole, the providers seem to take a stance where 'coders don't know their job as well as *we* do' in regards to coding and documentation. The way I see it, coders are trying to help the Providers. I just don't feel that they want to receive help.  I had one provider ask for coding/documentation help by phone one day, and when I told her I would be happy to meet, she cancelled 3 weeks in a row. I e-mailed her and let her know that I had some helpful information I could forward to her if she wanted the it and she never replied.  I would prefer a relationship with them where we work together to help each other. I want to understand what they do and I want them to ask for coding/documentation help.

I find that most of the physicians and management really do not understand all of the work involved in updating superbills, performing denials and education for a practice where we have over 200 physicians and many of them brand new who know nothing about coding and we have to teach them.  I feel very overworked, underpaid and not appreciated.

Helping providers understand coding can be stressful when providers don't have the right attitude towards coding.

Treated as any ther clerical worker, pulled to answer phones, financial counseling, management not certified, and often told my certification doesn't mean a thing.

Too much pressure to get claims out the door at the end of the month. If coding gets behind due to process flow, management would rather let claims go unchecked by coders & let them deny & work the problems at the back end. Management will not deal with issue between coders & doctors that wont dictate properly or not at all.

Providers code all electronic charts.  Picking from drop down menus to choose ICD-9s.  E&M coding must be done in order to close all charts within a 24 hour period.  Due to this there is a lot of choices being made without full understanding of consequences.  Coding department has to do much backend work for the providers.

I feel in our area of the country, CPC are looked at by physicians and practices as not necessary, I don't they understand fully the risks of not coding correctly, and think that our jobs are data entry.....We are still very underpaid in our area with our certification.

In the office or in the hospital, the Drs use a "cheat sheet" for E/M. For procedures, they are coded by the documentation from the Drs dictation. Some of the Drs. don't bother about improving their documentation in order to bill additonal codes, etc. As in the location of an additional biopsy. Report states "biopsy X three". They do whatever takes the less amount of time or takes less effort on their part. (Not all doctors are this way). The bottom line always shows which Dr has the adequate documentation, but doesn't seem to matter..

My employer puts all coding responsibilities on providers.  They are not interested in paying for coders and the providers are not interested in coding.  The "biller" remains responsible for collecting every ethical cent as quickly as possible without steering the provider toward any particular coding reconsiderations.  We're allowed to say "insurer denied for contracted radiology facility." and the provider is expected to infer that the diagnosis used does not meet the payors criteria for side-stepping the contracted radiology (per the payor list you have been provided by biller) & suggest corrective coding if the documentation supports it or concede to write off.  Generally these denials and requests for reconsideration are ignored until they are written off.

I think there needs to be emphasis on credentialing coders and getting them certified, regardless of the organization it's through.  Out of four coders in my office, I am the only one who is certified.  I am constantly finding errors, and have to correct them and explain why I'm correcting them.  If employers would understand the value of certification, instead of the possibility of saving a dollar or two by hiring non-certified coders, the profession would take an enormous turn for the better, and I believe pay scales would be higher, as well as the dignity and professionalism in having your credentials in the first place.

I do not have enough time with my work load to keep up with my CEUs.

I work for a teaching institution. 70% of our patients are Medicare. It has been a challange through the years collecting from Medicare, and now its become a nightmare due to the Medicare HMOs and PFFS. They have their own set of rules.

I do not beleive that I have been trained in the billing side of coding. I basically code E&M, surgery and OB/GYN and forget about it. If it is denied I may or may not find out about it.

The coding done by our providers can vary from very good to very poor.  We only have a few providers that do their own coding, so the question 5 above does not accurately reflect everyday situations here.  The majority of our providers are not concerned about coding and how it affects reimbursement, denials, etc.  And the providers that do code do a fairly good job, but do not like to have their coding changed, even when it's wrong.  And they really don't like being told that it's wrong.  The relationship between the coders and the providers is fairly weak.  We are working on it, but have a long way to go.

Coding accuracy is only as good at the payers adjudicating the claim.  There are many payer errors, typos, payer guidelines and inconsistent processing that leads to unnecessary denials.

I feel that a person's pay should not be based on if they are certified or not certified. Most times than not, coders who are certified know less than a coder who is not certified. I think pay should reflect years of experience and how well you do your job and not a piece of paper.

Underpaid and overworked

Training physicians to code is a work in progress. Some are receptive, and comply with coding regulations, others disregard everything taught and do it their own way anyway (usually wrong).  Another problem that is slowly getting better is lack of professional respect towards a coder from a physician. I think somtimes a coder is viewed at a skill level of a receptionist, when it requires very different skills, knowledge and experience levels. I think the role of a coder is continually evolving and is now being recognized as a profession in the eyes of the physician.

Coders are not provided with a quiet work area.  Seem to just sit them anywhere to work.  Climate is terrible in work area also.

I love my job but wish that I had more coding duties. I'm able to get my coding and charge entry work done early every day and spend quite a lot of time trying to find things to do.   It gets frustrating sometimes.

I work for a very large payer & the coding environment is not conducive to higher learning or even the need to be certified.

I think that coders are sometimes taken advantage of and perform so many other duties that it's very frustrating and difficult to keep up with CEUs and primary coding advances. Lots of office-juggling and workflow management takes place, I believe.

There are several employees in our office, therefore, we have cubicles not offices.  As a coder I really would like to see more offices for coders so that there could be more quieter areas for which to concentrate.

Everything has to be run by the nurse manager and doctor's wife who have no idea as to what's right and wrong.  Very frustrating if I point out errors to them and show them were they are wrong.  According to them, they are never wrong.

My only comment would be that space allotted to us isn't conducive to productivity. We have many people in a small area.     We do have a great education incentive here.     We have a tiered system starting with Dept. Chair, managers, coding advisors, then coders.

I feel that even though the practice is concerned that we don't have a certified coder, they will not pay for it because they are afraid you will want a raise or look elsewhere for a better paying job.

Very poorly mangaged work environment where the manager has no understanding whatsoever of coding, billing, reimbursement or compliance issues and shows no willingness to learn. This makes it extremely difficult for the coding and billing staff to do their jobs.

The work environment is very stressful .  Most of the time the work is chaotic since we are now beginning the implementation of EMR. I am a coding educator that has no management responsiblities and no authority over the coders or in my position. We do not have audit policies and procedures or a solid compliance plan in writing. The focus in my workplace is to be politically correct.  This is not an engaged work place. More of an "I don't care attitude" is prevalent. I try to provide positive feedback to the coders but in their words "only more money matters to me" I provide one-on-one coding education after prospective review audits for all E/M services for over 165 physicians, 25 mid level providers. I also provide one-on-one coding education for minor office surgery procedures, surgery coding all specialties (pediatric, adult, general, vascular, plastic, oncologic), pain management, mental health, cardiology, OB/GYN.  I am a one woman show and am underpaid for the level of service I provide. I love coding and education and hope some day to find an employment setting that has an engaged work force where management is directly involved with the employees and generate the attitude of you are valued.

the surgeons sometime don't realize how much time you spend on getting the charges coded out in a timely manner.  A lot is expended sometime.

heavy load of documents to code

The questions in this survey are biased toward employees working in a physician practice.  The survey should have been more interactive to exclude physician-based questions for people employed in other venues.

My employer is very close to committing fraud with their coding practices and I don't plan to remain in their employ. The work environment does not comply with OSHA standards.

I feel that in general people expect you to know it all because you are certified. The assumption is since you are certified you can answer any question immediatly. Dont think people understand how much there is to coding.  Don't feel physicians in general appreciate our expertise. They are the first to not listen or feel the need for your knowledge

There is a lot of negativeness at our work environment, not so much from our Doctors but from management.  You can't go to management with a comment, suggestion or desire and get any type of positive response.  I also would like to see a closer relationship with all employees and Doctors instead of only there nurses, secretaries and management, the billing people including the Coder does not have a very close relationship to the Doctors because we are pushed off across the hall and don't have any dealings with them.  It could be worse though, we do at least have a job.

We are a multi-specialty group and do privide training to docs to enhance their coding skills.  As with all training, some take it well and others do not.

Drs do not care to be specific in DX nor to legible documentation of notes.  They don't seem to care about HIPAA regs.  Being certified doesn't seem to matter for salary.  Management and pay of employees seem to be low on scale of priorities.

The work environment is good.  But training people to do coding is difficult when you have people who don't understand anything about coding.  I tell them how to bill and they do it.  They don't ask why because it is not important to them to learn.

Wish the atmosphere was more positivie instead of being intense all the time

I am under-paid & under appreciated by the physicians (11 docs & 2 PA's) I work for.  For the most part they're not accountable for their coding and are unwilling to listen to me. I am the only coder presently employed here and I'm responsible for all coding issues, surgeries, auditing, appeals, etc..

As a Certified Coder, I wish we got more respect from the Physicians.

I feel that their are a lot of other duties as assigned that sometimes take time away from being able to evaluate and research to apply the right codes to claims.  It needs to be a separate position than just put in as a biller to do all other functions along with billing.

It is hard when you are asked to work on something outside of your specialty. You are not as familiar with the guidelines that accompany that certain specialty. When you are out of your comfort zone you are bound to make mistakes and in this business accuracy is everything.

I would like to handle EOBs  We have an employee that just enters insurance cks and EOBs, but then I don't see how we are reinbursed per pt and insurance

After being certified for over 5 yrs as a CPC, I still have the problem with radiologists who transmit vague reports without sufficient documentation to bill claims for medical necessity.  Radiologists still insist on billing certain services because it is their "protocal" to perform a CT of Abdomen & Pelvis when the Abdomen was the only service requested by the referring doctor. My billing manager and I have repeatedly talked with these doctors to keep them up to date with CPT/ICD9 changes.  These meetings help for a while, however, the doctors seem to fall back to their same old ways if we do not keep on top of it.  Any suggestions on how to drive the point home to them?  Thank you.

My employer will not pay for me to get my national certification. I was told that I don't need it to work here. I also cannot go to seminars because we are a rural health clinc, and there are not many rural health seminars that come to ND. and the cost is too much money. I wish that would change.

The frustration with the coders in my organization is that very high standards are laid out by our Compliance Department and the coders are expected to uphold those standards. While the physicians do have to undergo mandatory auditing, those with bad behaviors are not truly re-directed since the medical directors always side with the physicians. No matter how hard the coders try to uphold those standards if a physician disagrees they are allowed to continue in those behaviors.

I am expected to do too many other job duties in my department that are time consuming and don't leave time for coding, such as physician credentialing.

My providers are going thru many issues.  They don't want us to question their coding but then expect to put many other expectations on us and when we do research and if it is not what they want to hear they get frustrated and challege us even if we have the backup.

The role of the coder changes in different settings. In my current position 10 surgeons 2 coders. We do auditing, denials, charge entry of clinical charge tickets and code operative reports. We try and do a monthly newletter for the docs, education to the fellows and compliance. The pay should equate with responsibility and years of experience and certification.I believe the role of the coder should be marketed in a larger scope than just coding...

Certified Coders should be paid for Coding and not be expected to do clerical work that could be done by someone else for less money. Where I work - Mom is the Supervisor of the daughter, they share the same office.

The volume is too much for the 22 hours per week I put it. I code for 14 providers

Support from Management is very minimal and we are informed certification is no mandated for our jobs. I would like to retire and seek a job in the private sector where i can be appreciated.

Unfortunately I feel like the group does not value their coders or the coders feedback, the coding department and the insurance reimbursement team need to work together, we have insurance gals correcting claims (coding)

Some colleague coders are ill-equipped to perform coding duties outside their particular area of experience.  In many cases, these are the same individual who refuse to gain continuing education in weak areas.

I have no time to research coding issues at work. I have been tasked for the past six years to bill claims in addition to coding encounters. I spend 90 percent of my time billing instead of coding.    I have no support to attend conferences or training provided by the AAPC Academy. If I want to attend outside hospital training, the cost will have  to come from my pocket.

I really do not have any outside contact with other coders.  I really do not have a basis to fall back on to know whether or not something is right or not.  I have requested to attend local chapter meetings only to be told no.  I have asked for more training on the E/Ms (because what's the point of my certification?) and that was started last Feb., dragged on and stopped in August without it ever being completed.  I haven't asked when it will be reinstated.    I am becoming more and more uneasy at work and really want to quit.  I am currently looking for another position.   This is the first coding job I have had and I am so grateful to have gotten my foot in the door on coding and have gotten experience.  However, now is the time to move on.  I just hope something comes up soon.  I might have to get more training as a CCS.     I know our back end staff is running one to two years behind on some claims.. (!)

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