What additional information should Molly gather?


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What additional information should Molly gather?


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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?

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%