As a leader and manager, the health information administrator is responsible for monitoring and evaluating the performance of processes. This responsibility requires the manager to determine key performance indicators to be included in the monitoring and evaluation process.
You are the Health Information Management director at Memorial Hospital. You are a member of the revenue cycle department and are charged with monitoring and evaluating key HIM RC processes that impact the stability and health of the facilitys revenue cycle.
During the claims, production process claims are scrubbed and modified to ensure that a clean claim is submitted to the payer. Memorial Hospital tracks claims through this process so that inefficiencies in the RC can be addressed. Below are the claims production data for April through June. The Health Information Management coding units clean claim metric standard is 95 percent.
Prepare a summary statement about the coding units quarterly performance. Create a graphic display (bar chart or line graph) that summarizes the coding units performance in relation to their standard. Is the unit performing as expected, or is there a need for a root cause analysis and process improvement? If there is room for improvement, brainstorm some ways the coding manager could educate the staff.
More details are attached in the uploaded file
Compare total number of claims processed to total number of clean claims for each month.
