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:
What additional information should Molly gather?
What are Molly’s options?
How can you ensure quality of coding while at the same time emphasizing volume?
What would you recommend to solve Molly’s problems?
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|
(per 8-hour day)
|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%|