DEPARTMENT: Health Information Management Services / POLICY DESCRIPTION: Coding: Additional Compensation Plans for Company-Owned Physician Practices
PAGE: 1 of 1 / REPLACES POLICY DATED: Oct. 1, 1999
EFFECTIVE DATE: September 2, 2003 / REFERENCE NUMBER: HIM.PHY.008
SCOPE: All personnel responsible for performing, supervising or monitoring coding of physician services including, but not limited to:
Regional Service CentersPhysician Services Coding Consultants
Managed Services OrganizationsHealth Information Management Services
Owned Outpatient Clinical Office Administration
Physician Services Operations Support Physician Practice Management
Physician Services Compliance Consultants Ethics and Compliance Officer
PURPOSE: To ensure that Coding Incentive and Bonus Pay Plans are NOT used for any Company employees involved in the performance or auditing of coding processes.
POLICY: Coding Incentive and Bonus Pay Plans are NOT acceptable for use within the Company.
Lump sum payments for special projects, clean-up projects unrelated to coding indicators, and employment/sign-on are acceptable.
Representations by healthcare providers employed by HCA Physician Services (HCAPS) as to the services provided to patients (including representations as to the level of service, when a level must be designated) are not considered to constitute coding for the purposes of this policy.
PROCEDURE:
  1. Coding incentive and bonus pay plans must NOT be implemented for any Company employees responsible for performing, supervising or monitoring coding for Physician Practices. Examples of coding incentive and bonus pay plans that are prohibitive include, but are not limited to the following coding indicators:
a. Percentage of major surgery;
b. Evaluation and Management Levels of service; and
c.Accounts Receivable Days/Dollars; or
d. Other coding indicators that are impacted by factors beyond complete, accurate and consistent coding.
  1. Coding incentive and bonus pay plans must be terminated immediately. Consult the entity’s Legal Operations Counsel for advice on contract termination.
  1. Current coding incentive and bonus pay plans must be reviewed with the management staff of the entity to determine an immediate and appropriate compensation transition plan.
  2. Consult the Human Resources Department for advice on coder compensation plans.
  1. Health Information Management Services and HCAPS will review and monitor coder compensation plans.

REFERENCES: Coding Documentation for Company-Owned Professional Services Policy, HIM.PHY.001

10/2003