Question

Select and describe the two most important key performance indicators that you believe a coding manager could include on a coding unit dashboard. Support your selection. Students may select any of the following six key performance indicators to discuss: CMI, Denial Rate, Clean Claim Rate, DNFB, Pepper Metrics, CC/MCC capture rate.

Answer 1

The Clean Claim Rate and DNFB rate are two important KPIs for a coding manager, as they reflect coding accuracy and directly affect the revenue cycle and cash flow.

Step-by-step explanation:

Two key performance indicators (KPIs) that are pivotal for a coding manager to include on a coding unit dashboard are the Clean Claim Rate and the DNFB (Discharged Not Final Billed) rate. The Clean Claim Rate represents the percentage of claims that pass all edits without manual intervention on the first submission. This rate is crucial because it directly relates to the revenue cycle efficiency and indicates the accuracy of coding and billing processes.

Conversely, DNFB refers to revenue tied up in claims that are ready to be billed but have not been submitted due to coding or documentation issues. Reducing DNFB times can significantly impact cash flow and revenue, highlighting the necessity for efficient and accurate coding practices to minimize delays.