HIM Growing into Revenue Cycle Roles

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HIM Growing into Revenue Cycle Roles

By Lou Ann Wiedemann, MS, RHIA, CDIP, CHDA, FAHIMA, interim senior vice president, member services

Change is a constant, as I am reminded when my smartphone updates its apps or when I have to learn how to use new software. “How does this work now?” I mutter under my breath, trying to accomplish something that was effortless last week and now doesn’t seem to make sense.

As HIM professionals, we may have the same feeling about our work—which, without a doubt, is different than it was five years ago or even two years ago. This is true for every area of HIM, but particularly true for coding—where we find people moving into new roles that call for the same skill set but apply those skills in different ways. The jobs of the future will require different knowledge and less application of codes in the traditional way, requiring people to use their coding knowledge in new contexts—such as this month’s issue topic, revenue cycle management.

For years, we have been aware of the important role HIM plays in the revenue cycle process. This knowledge is especially important today with the creation of new payment methodologies and the advanced pace of technology that impacts the revenue cycle and the rest of our work.

The articles in this issue explore some of the ways HIM professionals can impact the revenue cycle. One particular area of opportunity—or frustration—is auditing. The number of audits facing HIM professionals is growing as the government, payers, and providers seek to better manage costs and improve care. When there isn’t much coordination of audits at the organization level, the work typically falls to HIM. Audits can be high-stress events, with tight timeframes to pull and send information. But they can also help uncover system issues or habitual errors that we can correct. In “Attack of the Audits,” Lisa Eramo reviews the various internal and external audits impacting HIM departments, talks about pain points, and discusses steps organizations can take to prepare.

Now that we’ve moved beyond implementation of ICD-10, organizations have begun conducting coding audits to ensure high levels of coding quality and productivity. Sarah Humbert describes the various methods and metrics used for coding audits and offers some predictions for coding audit progress in 2018 in “How to Choose the Right Coding Audit Method.”

Finally, biometric technology such as facial recognition is becoming cheaper and more prevalent, even making its way into electronic health records. Facial recognition could even potentially serve as a federated patient identity in some future era. But for all its potential, facial recognition has its dangers as well. Valerie McCleary digs into the topic in “Smile, You’re On Facial Recognition.”

AHIMA is here to support you as you tackle audits, revenue cycle, or even biometrics. Let us know how it’s going! Contact us at journal@journal.ahima.org.