Where have all the good companies gone? For years, coders have been under pressure to complete charts quickly to keep the finance side of the medical facility happy. While at the same time, they are told their coding must be near perfect. Heaven forbid a query or a piece of missing documentation is necessary, because it holds up the bill. Then there are the in-house or third-party reviewers who come in behind the coder while on an impossible deadline to meet productivity, quantity and quality.

I was in a meeting recently and we were discussing a struggling coder who has great potential. The vice president district manager of a company said, "We don't have time to teach her what she doesn't know. Coders are easily replaceable."

I thought to myself, what happened to loyalty? Does this mean experienced coders and quality assurance (QA) reviewers are next? Is it because of the poor economy that workers are desperate and companies are truly taking advantage of a bad situation? Companies seem to want loyalty from their employees, but it's one sided. Coders used to be trained on the job; they were mentored and shown the true ropes. Now facilities don't want to touch them. Coders are told to go to school, but when they finish their degree, they can't get a job because they don't know the ropes (or have 3 - 5 years' experience).

Coders are under a great deal of stress, just as MTs are. We are not easily replaceable or expendable! Coders need to understand up front what they are getting into, and most don't realize the pressure and stress they will feel every day by Medicare, management, billing, QA reviews, RAC and third-party consultants. They aren't taught this side of things in school. Mentor programs need to come back into facilities because coding isn't black and white. It never has been and never will be. Coders, QA reviewers, coding managers and outside consultants can all look at the same chart and interpret certain parts of the documentation differently. And with ICD-10 coming soon, everyone will basically be equal on the playing field. This will be a wake-up call for management when there will be no real experienced coders. This is where good mentoring and training programs come into play; each company/facility has to invest in their coders for this training.  Coders are not easily replaceable, and loyalty is a two-way street that needs to come back.

Joyce Eggert
Via e-mail