Question

Molly, the coding supervisor of Homer General Hospital, has a problem. Her Discharged Not Final Billed (DNFB) report is staying significantly over the limit that administration desires. She is also behind in some of the compliance monitoring that needs to be completed. Molly has been given the mandate to determine what needs to be done to bring the DNFB down and still maintain quality, as well as keep current in the compliance monitoring. She pulled together the information shown in the table below. Analyze this situation from every aspect, including but not limited to quality, legal, and management, and answer the following questions:

What additional information should Molly gather?

What are Molly's options?

How can you ensure quality of coding while at the same time emphasizing volume?

What would you recommend to solve Molly's problems?

Data Table

Analysis for Discharged Not Final Billed (DNFB)

Number of current employees	Coding supervisor	1
	Coders (all types of charts)	3
Number of vacant positions	Coders	1
Volume (average per day)	Inpatient	70
	Outpatient	177
	Emergency Room	122
	Outpatient Surgery	90
Productivity Standards (per 8-hour day)	Inpatient	25-28
	Outpatient	170-185
	ER	120-125
	Outpatient Surgery	85-100
Amount of time currently spent on compliance issues	Hours per week	10
Amount of time that Molly feels should be dedicated to compliance to do it right	Hours per week	32
Current DNFB	$1.2 million
Desired DNFB level	$600,000
Aging	Current charts (3-day bill hold)	35%
	4-10 days old	20%
	11-21 days old	15%
	22-30 days old	15%
	More than 30 days old	10%

Answer 1