Policy
Question1234
coding_quality_policy.docxABC Medical Center
Coding Quality Policy
ABC Medical Center must uphold a high level of coding accuracy expectations to meet internal standards, JCAHO and Medicare standards, and other regulatory expectations. In order to assure compliance with these standards, each coder will be audited on a quarterly basis by review of a random sample of their work. The following quality standards are expected:
Veteran Employees
1. A random sample of 20 charts will result in a 94% or higher accuracy rate.
2. A coder not meeting the quality standard will be put on an education plan developed by the Coding Manager. The Coding Manager will work with the coder on a regular basis to monitor training and improvement.
a. The next quarter’s audit should show improvement up to the 94% standard. If the 94% standard is not met, the coder will be placed on a 3 month probation.
b. If the 94% standard is not met at the end of the 3 month probation (2 consecutive audits), the coder will be subject to termination.
New Employees
1. A random sample of 20 charts will result in a 94% or higher accuracy rate.
2. New coders will be placed on probation during their first 6 months of employment.
a. Coders should reach 80% accuracy rate during the first 3 months of the probation. A continuous improvement is expected over the duration of the probation period.
b. Coders are expected to reach a 94% accuracy rate by the end of the 6 month probation period.
3. New coders not meeting the quality standard at the end of the six month probation period will be placed on an education plan developed by the coding manager. The Coding Manager will work with the coder on a regular basis to monitor training and improvement.
a. The next quarter’s audit should show improvement up to the 94% standard. If the 94% standard is not met, the coder will be placed on a 3 month probation.
b. If the 94% standard is not met at the end of the 3 month probation (2 consecutive audits), the coder will be subject to termination.
