Pediatric Coding Quality and TAT Improvements

Client Profile:

Full-service pediatric healthcare center covering a five-state region.

Challenge:

Following a switch to EPIC and the metrics they offered, the group recognized a significant need to improve their coding quality and turnaround time TAT performance. Leadership of the center wanted a full-service operational partner with a strong knowledge of pediatric coding to clean up these daily operations concerns, conduct a thorough assessment of their cancer registry program, and assign a dedicated coding manager to ensure ongoing success.

Approach:

AQuity Coding leadership met with the key partners leading the initiative for better coding results to review existing performance metrics and define target success metrics. Together, they built a partnership based on open communication to identify what was working well and where there was room for improvement. With strong leadership and pediatric coding experience, AQuity provided guidance and took a consultative approach. A dedicated coding manager and team were hired prior to the go-live date, equipped to take on multiple projects, including a thorough audit of the client’s cancer registry program, claims edit and denials process, and cardiovascular charge coding. AQuity discovered a gap of over a year in mandatory cancer reporting and initiated a registry effort to bring the client into compliance. Due to early success, AQuity was further asked to audit numerous other programs, including parts of the revenue cycle management that affected coding success, and to take over their emergency department coding.

Results:

AQuity’s Coding team achieved:

  • Reduced the client’s coding TAT and optimized the revenue cycle management efforts to lower DNFB from 3.2 to 0.4 in the first six months, then continued that target of less than one half day while maintaining quality excellence
  • Met and exceeded Coding production quality and turnaround time objectives
  • Discovered a mandatory cancer reporting gap and brought the client into compliance
  • Audited several revenue cycle management processes and made changes that measurably improved full process cycle performance

To learn more about AQuity Solutions coding support services, contact us today at info@aquitysolutions.com.

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Medical Coding Services

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