Coding Crash Course

Community Health Systems is finding a way to ensure its employed physicians are properly coding and capturing charges: Make it fun to learn. For the past nine years, Brian Peoples has held a three-day seminar to teach the for-profit hospital operator’s employed doctors how to get the right codes out the door and the right amount of cash back in. But Peoples, vice president of physician practice support, jokes that he’s not the head “physician policeman.” During the training at Community’s headquarters in suburban Nashville, TN, physicians go through several general training modules before dividing into groups on their own according to specialty.

The training sessions have helped many of Community’s doctors “not only document but code themselves,” says Peoples. Physicians use Community’s standardized code sets embedded in software used at all of the company’s owned practices.

But Community’s leaders recognized that as many hospitals return to the employment model, there are several built-in advantages with training its physicians in this way. First, many of the physicians who practice at its hospitals are from owned practices; it’s part of their job to do what the company wants them to do. Second, many of its physicians are on production-based agreements that reward physicians for efficiency without violating regulations on physician self-referral. “With healthcare reimbursement dropping we’re becoming more and more proactive in sharing the risk and putting them on production-based agreements,” says Peoples. “At that point, they want to know how well they’re doing with documentation and coding.”

Finally, he says, “if you approach it as an educational and learning experience, rather than trying to correct what they’re doing wrong, it works much better.”

If for some reason a Community physician can’t make it once a year to the training session in the “big city,” (most of Community’s doctors practice in rural areas), no problem, he says. Peoples and his team will come to you. “We have to be proactive,” he says, “because each year the rules change and CPT codes are added and dropped.”

As for the training, bringing a group of 35-55 docs to company headquarters every few months for a couple of nights on the town after some intense computer training may be fun, but it’s also becoming more necessary than ever, Peoples says.

“Physician employment is only going to get more common,” he says. “Volumes have softened, and incremental out-of-pocket expenses have caused people to avoid services, so it’s more important than ever to get this part of your business right.”

—Philip Betbeze