What would you recommend to solve Molly’s problems?
Molly, the coding supervisor of Homer General Hospital, has a problem. Her Discharged Not Final Billed (DNFB) report is staying significantly over the limit that administration desires. She is also behind in some of the compliance monitoring that needs to be completed. Molly has been given the mandate to determine what needs to be done to bring the DNFB down and still maintain quality, as well as keep current in the compliance monitoring. She pulled together the information shown in the table below. Analyze this situation from every aspect, including but not limited to quality, legal, and management, and answer the following questions:
1. What additional information should Molly gather?
2. What are Molly’s options?
3. How can you ensure quality of coding while at the same time emphasizing volume?
4.What would you recommend to solve Molly’s problems?
Data Table
Analysis for Discharged Not Final Billed (DNFB)
Number of current employees
Coding supervisor
1
Coders (all types of charts)
3
Number of vacant positions
Coders
1
Volume (average per day)
Inpatient
70
Outpatient
177
Emergency Room
122
Outpatient Surgery
90
Productivity Standards
(per 8-hour day)
Inpatient
25-28
Outpatient
170-185
ER
120-125
Outpatient Surgery
85-100
Amount of time currently spent on compliance issues
Hours per week
10
Amount of time that Molly feels should be dedicated to compliance to do it right
Hours per week
32
Current DNFB
$1.2 million
Desired DNFB level
$600,000
Aging
Current charts (3-day bill hold)
35%
4-10 days old
20%
11-21 days old
15%
22-30 days old
15%
More than 30 days old
10%