The new job has gotten off to an interesting start. Right now I am in the best possible situation at my workplace. This is not such a great thing for the lady who has been in charge of the coding before I got there. For her, it is the stuff nightmares are made of. She is probably writing a bitter blog somewhere about the Bosshole she works for and the evil bish they hired to expose her mistakes. Seriously, it probably looks like a big set-up to her.
I feel that there is plenty of room for both of us to work and prosper there at that hospital. It's a bigger, faster paced operation and the workload does warrant having 2 people in there handling the department. We are very different in our approach and I am a consultant, so I am very aggressive about finding the money and making sure all the elements are in place to optimize the payment and keep the hospital compliance standards for the type of payment system we operate under. She's not coming from a consultant perspective and she doesn't know how to optimize. As a result, the facility has been losing money that they could have had and were entitled to. She just missed it. Lots and lots of it. The first thing my new boss wanted me to do was audit what has been done and resubmit anything that was done wrong. This is changing their entire financial future because they have been making ALL the mistakes. It's like shooting ducks in a barrel for me. I can just glance at a case and see what went wrong. The dollars just pop out at me. They wanted a consultant... they hired me... and now they want to know what has been done wrong. Are you seeing my problem here? My new co-worker is going to hate my guts reeeeally soon. I feel bad for her and I feel bad about having to reveal my findings, because it's baaaaaaad. It's very, very bad. The whole hospital only had optimized billing on 17% of their total cases before I came there. That percentage is climbing radically by the day. All this time the other coder has been telling them the good paying diagnoses were just not there, but they are and they always have been!
In physical rehab hospitals, we use the "motor score" to sort of establish how much help the patient needs. The length of stay and the payment level is determined by that score. The lower the score is, the more money and time you get to treat the patient. Many hospitals score the patients too high and lose a lot of money that way. They have been really missing the mark on that. I've found many mistakes in their process and the other coder feels it is not her job to monitor that, so she has been entering these high scores, further screwing the payments received.
Already, the boss wants me to take over doing all of the financial stuff and handle up on that score situation to stop the loss. This is not going to sit well with the other girl who will surely feel like she is being displaced. She is going to be running reports, and doing lower level stuff while I do the money stuff.
So things could get rough around there when she realizes how much things are going to change and how much is going to be taken out of her hands. She's going to be hatin' on it full time. I think I'd have to actually commit murder during the work day and mess up the carpet in order to be seen as anything less than an angel sent from heaven by my new boss. This is why I like rehab. I can show really good results really fast.
I have tried a little to point out to the other girl some tips about finding the good stuff and how to find the lower scores ans report those for better outcomes, but she is not having it. She doesn't realize that this would help her greatly to be open to doing a more comprehensive job of it. I'm not pushing it. This has been her turf since the place opened and it's going to be plumb ridiculous how fast I will be changing life as she knows it. It's going to go my way, because I am an expert at optimizing payment and that is what every boss up the food chain is interested in. The money wins. Simple as that. They are also interested in doing it right and staying within our compliance so we won't get in trouble or lose our rehab status.
I hope she doesn't get mad and quit. I'm really not trying to victimize her. It just has to be done and if it wasn't me they hired to come in and fix it, it would have been some other rehab specialist to come in and do the same thing. This is one time when it really and truly is not anything personal, it's just my job.
WOO, LATE! I have to go to bed.