Home health organizations often face significant challenges in managing OASIS scoring and coding, a critical component of patient care and reimbursement processes. Despite the importance of accurate OASIS coding, many organizations struggle due to several underlying issues.
Why Organizations Struggle with Medical Coding
One of the main challenges is clinician competency. Inconsistent performance in assessments may stem from variations in training methods. To build strong OASIS-E competency, you’ll need to implement ongoing training that leverages repetition and real-time application. This approach, when coupled with standardized materials and incremental competency measurements, can help clinicians achieve consistent accuracy. Clinician health is a factor that is often overlooked, but it also plays a pivotal role in continuous OASIS coding accuracy. The demands of OASIS coding, on top of existing responsibilities, add to burnout and stress, which affects clinician performance. Addressing these issues with flexibility and support are methods to try and improve their well-being, which ideally leads to better outcomes and retention.
The effects of poor OASIS coding include inaccurate documentation of patient acuity, challenges in preventing hospitalizations and obstacles in capturing data for value-based care. Without timely intervention, these issues can build up, affecting both patient care and financial performance. The lack of a robust feedback loop tied to learning needs hinders continuous improvement in coding practices, allowing practitioners to get off-track in terms of coding accuracy. Establishing data-informed feedback mechanisms is crucial to identify areas for improvement and elevate team performance.
Another hurdle is collecting Patient Health Questionnaire (PHQ) data, which includes social determinants of health (SDOH). This can lead to reduced reimbursement, emphasizing the need for effective documentation support. By recognizing these challenges and potentially outsourcing coding to a specialized company, healthcare organizations can work towards reducing these risks and focus on delivering high-quality care.
Choosing the Right Medical Coding Consulting Company for You
There are plenty of options available when choosing a medical billing and coding company. But it can be challenging to find the best healthcare coding and consulting service for your organization. It is important to evaluate your organization’s size and needs when looking for a medical coding consulting company that can meet your requirements. When you are looking at a company to employ for help, it is important to do your homework. Look for medical coding consulting companies with proven experience and research what other healthcare providers have said about them.
Another factor to consider is whether the company you are looking at is proficient in handling billing and coding for your specific medical specialties. This expertise can impact the accuracy and efficiency of your work, as a company specializing in another field may be decent at coding for your specialty, but they may not have the background to understand the intricacies of your patients’ needs. You also want to make sure the medical coding consultant has the staffing and ability to manage your account effectively. With that in mind, you only want to pay for what you can afford so keep in mind the need for quality services within your budget. Compliance and security measures are non-negotiable; HIPAA compliance and robust IT systems are vital to protecting patient information.
Tips for Coding Success
To maintain real-world home health coding success, practice is important because efficiency comes through repetition. But you will want to make sure to focus on accuracy before worrying about your speed. Being open-minded and teachable can make a significant difference, as coders who embrace the latest information and continuously learn are more likely to succeed.
Seeking out a mentor and learning to navigate the alphabetic index efficiently can also enhance your coding skills. It is important to focus on the scope of your duties and not get overwhelmed by aspects outside your control.
The McBee Standard
McBee partners with healthcare organizations to develop sustainable strategies tailored to specific clinical, operational and financial goals. McBee’s systematic, disciplined approach to compliance involves identifying trends and making detailed recommendations that reinforce best practices, optimize processes and reduce risk.
Our OASIS and ICD-10 coding services are designed to enhance clinical and financial outcomes, with a commitment to accuracy demonstrated by their 96% minimum accuracy rate. With more than 25 years of clinical and coding experience, McBee’s team is equipped to oversee any challenge. We offer extensive training, continuing education and a robust internal quality assurance program, helping clients receive the highest level of service. Additionally, our coaching and mentor program provides ongoing support to help organizations achieve long-term success.
Choosing the right medical coding consultant is critical to overcoming the challenges of OASIS coding and achieving success in home health care. By addressing clinician competency, ensuring continuous improvement and selecting a partner like McBee, organizations can navigate the complexities of coding with confidence and focus on delivering the best possible care to their patients.
About the Author
Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, VP of Education and Quality
Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, is the VP of Education & Quality at McBee, bringing over 35 years of expertise in home health and hospice. As a registered nurse and home care attorney, she specializes in regulatory compliance. Lisa has held various roles, from field nurse to executive, managing accreditation surveys, acquisitions, and regulatory crises. In 2004, she founded Selman-Holman & Associates, offering consulting, coding and OASIS review services. Lisa is a renowned educator, known for turning challenges into achievements. Joining McBee in 2021, she leads education initiatives at the Post-Acute Academy, providing courses for home health and hospice staff and executives, including clinical, regulatory and onboarding requirements.
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