Coding Confidence: Do You Have It in Your Locum Providers?

Physicians are measured by an array of metrics today: Contribution to length of stay, readmit rates, patient satisfaction, among others. But what about a locum physician’s contribution to reimbursement levels? How do hospitals ensure locum doctors are skilled in DRG coding, and doing it accurately?

It’s not an easy task. Granted, we physicians are taught in medical school the clinical importance of keeping a detailed and accurate medical record—to provide a reference library that may serve a vital clinical need in the future. We also know that the new system of ICD-10 DRG coding came about through the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and its efforts to facilitate the electronic transmission of health information. That’s a good thing, too. But it still doesn’t mean we like it.

Countering the “Afterthought” Mentality

As one of our physicians said recently: “Most of us just want to take care of patients. Documentation is sometimes an afterthought.” We’re not talking about willfully ignoring the responsibility to code accurately. But in the stress of a typically busy day, with attention focused where it should be—on patients—it can be easy to let paperwork details slip by—details that can end up costing a hospital big money.

At LocumConnections, we have found two simple answers to the “afterthought” mentality, and to be sure locum doctors keep proper coding techniques top of mind in everything they do on the job.

1. It takes training and resources.

Through comprehensive training in proper documentation and coding, and an audit process to catch coding errors and pinpoint the “outlier” physician or physicians responsible, we are known for having a unique and intense focus on preventing coding errors. Regardless of where our doctors live or where they are sent on assignment, we make sure their coding skills are uniformly solid across the board. We intend to keep it that way. We provide physician-to-physician education and electronic tools to improve accuracy. We also provide our locum physicians with timely access to coding experts via phone or e-mail whenever they need assistance.

It’s a strong safety net to ensure physicians navigate the complex coding maze accurately and thoroughly. The result? Our partner hospitals don’t miss a penny of the reimbursement they are due from Medicare and insurance providers.

2. It takes trust.

There are countless theories on what motivates people to do their best work, but one thing tops the list in our book: At LocumConnections, we build an environment of trust. In ways large and small, we let our doctors know that we have their back and are looking out for their best interests. We find the right assignments for them, pay them well, provide concierge-level travel arrangements tailored to the individual down to the tiniest personal detail—like whether feather or synthetic pillows are preferred at the hotel that is “home” during a locum assignment.

As a result, our doctors are a lot more willing to follow our plan in every aspect of clinical care—including accurate coding and documentation. Pair this with our company’s commitment to provide locum doctors who don’t simply fill an empty slot but who make a contribution to the health and well-being of the hospitals where they work, and you have a powerful combination. Our partner hospitals take confidence in that.

By Talbot “Mac” McCormick, MD

Locum Tenens Pricing: A Fundamental Shift is Just What the Doctor Ordered

Every young industry has its growing pains, and the locum tenens physician market is no exception, especially when it comes to its cyclical pricing model. In many cases, the cycles have been a roller coaster ride in recent years.

Some locum tenens placement firms drive the roller coaster. They mark up prices as demand increases, and do so with little regard for healthcare budgets or the long-term impact of their pricing on a hospital or physician practice’s financial health. Healthcare organizations are often all too willing to do business with these firms to fill an immediate need, and often make short-term decisions based more on emotion than rational thinking.

Working in various physician leadership roles as a hospitalist for more than 10 years, I have seen it all. And now as President and CEO of a locum tenens firm, I want to do something about it.

No More “Fulfillment at Any Cost”

At LocumConnections, we support new models that are bringing equilibrium to an erratic market. Healthcare organizations are taking many cost-trimming approaches seriously while infusing quality performance measures, and are looking for partners in recruitment and retention who want to help them achieve their goals.

In response, staffing firms are streamlining their processes in an earnest effort to reduce costs—implementing Vendor Management Systems (VMS), for example, to reduce time-to-fill cycle length and help them work more efficiently. Managed Service Providers (MSP) can have the same impact. Many of the larger locum tenens firms are incorporating these tools into their business as they seek sensible ways to avoid the “fulfillment at any cost” trap.

Another model is emerging, too. A firm like ours that has its roots in hospital and practice management can put its experience to good use. LocumConnections’ roots grew from actual case studies of clinical recruitment and staffing success in mitigating challenges with hospital partners in the temporary contract hospitalist sector. In short, our model is built on success, for success.

Prudent, Sustainable Solutions

We use a VMS system, too, to make our sourcing processes as efficient as possible. But we also take a consultative role to make staffing decisions that do more than just meet a hospital’s immediate need for a doctor. We take into account the long-term as well as the short-term impact. And because of our medical experience, we are able to put ourselves in the shoes of the physicians and healthcare organizations we work with and respond with a solution that is prudent, compassionate, and sustainable—not just for the organization, but for the healthcare industry, as well. Quick fixes just won’t suffice any longer.

The Association of American Medical Colleges predicts a shortage of up to 90,000 physicians by 2025 if the healthcare sector fails to aggressively adopt more efficient care and payment models. All the more reason for a fundamental shift in the way staffing challenges are addressed, at prices hospitals can afford, and for doing so today. That’s why we’re here.

by Talbot “Mac” McCormick, MD