The process needs to be fixed
As a physician, Dr. Z shares how he has seen problems in the process of coding since the beginning of his career. Many people in many different roles touch these codes in the paperwork and documentation as they make their way to the payer which leaves room for mistakes. And if the documentation goes out the door wrong, you don’t get paid. This applies to both private practice and hospitals.
In fact, Dr. Z highlights that even after identifying this problem years ago, when his team audits hospitals today, this is still a prominent issue happening in 70‑80% of hospitals. It’s not only that many different people who do not communicate often touch these codes, it’s also important to note that these codes are complex and constantly changing. Keeping up with this alone is a challenge.
4:15 “People at hospitals tend to be very siloed…and when everybody is doing their individual jobs and passing it onto the next person without a single point of accountability or a single process to make sure that it gets out the door correctly, the errors happen. Multi-billion dollar organizations change slowly and a lot of them don’t even know this is happening and once they’re aware of it, it’s a multi-year process to make some of these changes.”