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 (This is for my health care reimbursement class..I didn't know what

subject to put that under since medical wasn't an option) I need help with this- I have no idea where to even start.

The health information management team at Anywhere University Hospital (AUH) contracted with an auditing firm to perform full assessment coding review. The results from this baseline assessment are provided in four tables: Variation Log by Type of Error Variation Log by Coder Variation Log by MS-DRG MS-DRG Relationship Assessment You are the inpatient coding manager at AUH. Your director has asked you to develop an ongoing review and monitoring schedule for the next year based on the results from the outside review. Include internal and external reviews, coding in-services, physician workshops, and external seminars/educational sessions that will be performed and or provided for your staff. The schedule should be specific (include volumes and/or percentages of charts to be reviewed). Keep in mind that on average it takes 18 minutes to review one inpatient chart. Budget provides for $65,000 for external reviews. The average cost for reviewing one inpatient record by an external review team is $55.00 (fully loaded). In addition to preparing the schedule, outline how you will maintain coding quality statistics and report them back to the HIM Director and Compliance Committee at your facility. How will you reward your staff members who show great improvements? How will you reward and/or recognize that your staff has made improvements overall? Your Coding Team consists of: Coding Manager (you) 1-Data Quality Auditor (1 FTE) 8-Inpatient Coders (8 FTE) 2-RHIA, CCS 3-CCS 3-RHIT Results of the full assessment coding review for AUH: Two audits were performed: 1. Coding quality review by MS-DRG 2. MS-DRG Relationship Analysis Variation Log by Type of Error % of errors Inaccurate sequencing or specificity principal diagnosis, affect MS-DRG 17% Inaccurate sequencing or specificity principal diagnosis, non affect MS-DRG 16% Omission CC, affect MS-DRG 33% Omission CC, non affect MS-DRG 2% Inaccurate principal procedure, affect MS-DRG 3% Omission procedure, affect MS-DRG 4% More specific coding of diagnosis or procedure, non affect MS-DRG 12% Inaccurate coding 5% Missed diagnosis or procedure code 8% Variation Log by Coder Coder Error Rate Standard Coder 1 3% 5% Coder 2 9% 5%
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Coder 3 8% 5% Coder 4 2% 5% Coder 5 4% 5% Coder 6 16% 5% Coder 7 12% 5% Coder 8 3% 5%
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Health care reimbursement Review and monitoring schedule assignment.docx
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Subject: Business, Economics

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