Eastern Maine Healthcare - ACDIS Forums



Purpose: Provide Health Information Coders who have completed the 8-12 week training period the opportunity to work remotely.

Policy:

Upon acceptance of all terms of this agreement by the user (Health Information Coder), EMMC will supply all required hardware and software to enable the function of home-based coding. The equipment remains wholly owned by EMMC and as such its usage is governed under the guidelines provided by EMHS and will be separately documented when the user (Health Information Coder) receives his/her computer.

Eligibility for Remote Coding:

New Hires Completing In-house Training (8-12 weeks)

• Orientation and Training on site for 8-12 weeks (either consecutive days or 1x week for 2 months)

• Experience in job functions as demonstrated by work history on application for position for at least 2 years

o Inpatient

o Outpatient Surgery

o Outpatient Ancillary

o Physician Professional Charge Capture (E/M Leveling)

• Credentials needed for position:

o RHIA, RHIT, CCS, or CCS-P for Inpatient Health Information Coder 1

o RHIA, RHIT, CCS, CCS-P, CPC, CPC-H for Outpatient Health Information Coder 1

Coders who have trained/worked in-house

• Completed Orientation & Training

• Experience in job functions as demonstrated through onsite training

o Inpatient

o Outpatient Surgery

o Outpatient Ancillary

o Physician Professional Charge Capture (E/M Leveling)

• Credentials needed for position:

o RHIA, RHIT, CCS, or CCS-P for Inpatient Health Information Coder 1

o RHIA, RHIT, CCS, CCS-P, CPC, CPC-H for Outpatient Health Information Coder 1

The employee and the manager will review the following agreement:

|I understand that I must work weekdays on the first shift, and designate one of the following agreed upon schedules. |

|6-2:30 |

|7-3:30 |

|8-4:30 |

|9-5:30 |

| |

|Other:__________________________________________________________________________________________________________________________|

|_________________________________________________________________ |

| |

|I understand that in order to remain working from home I must increase my productivity each month until I have met the standard.|

|The following are the productivity standards set for the HeIS Coding department: |

| |

|7 per hr. – Ambulatory Surgery/OOU/ENDO/DPT |

|45 per hr. – Ancillary |

|8 per hr. – Emergency Department and/or Clinic Visits |

|20 per hr. – Accounts not ready to bill (Late Report) |

|2-3 per hr. – Inpatient accounts |

| |

|I also must increase my QI each month until I meet the standard. The following are the QI standards set for the HeIS Coding |

|department: |

| |

|95% - Principal Diagnosis code assignment |

|95% - CPT code assignment |

|95% - DRG assignment |

|90% - Secondary Diagnosis code assignment |

|85% - Evaluation & Management level assignment |

| |

|If I fall below either of these standards (productivity, QI), for a consecutive 2 month period I will be required to return |

|in-house at my manager's discretion for as long as deemed necessary by my manager before returning to at-home status. |

|I understand that I must have a secondary means of contact; whether that is a phone line, beeper or cell phone. This is |

|required in case the EMHS e-mail system is unavailable and my supervisor needs to contact me. |

|I understand that all rules that apply to days off/time off also apply to working at home. |

|I understand that any and all overtime must be pre-approved by the manager. |

|I understand that I am to take my breaks and meal break as I would in-house. |

|I understand that I am to provide my own workstation and chair and that I must have an initial OT evaluation of the site after |

|starting to work remotely |

|I understand that my workstation must be in a designated area within my home conducive to work. |

|I understand that EMMC reserves the right to inspect my home workstation with reasonable notice. |

|I understand that I must provide a high speed internet connection (cable, DSL, etc.) to the EMHS network. |

|I understand that I must submit my time using the Quick Badge function in API. |

|I understand that if for any reason I am not able to access the network from home (power outage, connectivity, PC malfunction, |

|etc) I will be required to work in-house for the remainder of my shift and any consecutive shifts in which I am unable to |

|connect. – Waiting period of 2 hrs. before decision is made about coming inhouse. |

|I understand that should the workload shift and resources are needed on the inpatient/outpatient side, and provided I’m |

|cross-trained, I may be required to code inpatient/outpatient charts on-site. |

|I understand that I am required to attend on-site my annual evaluation, biweekly coding compliance meetings (or connection via |

|Lync), quarterly Employee Forums, and any other meeting/in-services my manager deems appropriate. |

Sanctions

Non-compliance with any of the above terms may result in the revocation of my ability to work from home.

References

Remote employees shall abide by all departmental, and IS policies while working from home. The following HR and IS policies are listed as a reference:

Compliance Plan

Information Systems Acceptable Use

Information Security

IS User Audits

Human Resources Policy Manual (available from home page)

Confidentiality of Health Care Information

Employee Access to Own Medical Records

Violations of Privacy, Confidentiality, Security

Code of Conduct (available from home page)

Incident reporting

Ergonomic Work Station Recommendations

1. When making an adjustment to the workstation please consider the following:

• Adjustment to one piece of equipment will often affect the remaining setup.

• If an adjustment is being made, be aware of the reason why the change is being made besides the idea of comfort.

• Consider the porridge concept. Try multiple degrees of an adjustment to find the “just right” setup.

2. Guidelines for Workstation Setup:

• If one work surface is used for both the monitor and keyboard, the depth should be 30 inches deep to allow for adequate distance between the keyboard and monitor.

• The height in this situation should be no more than 26-28 inches and could potentially be less depending on the individual’s size. If the individual is less than 5’4”, consider 26” or lower.

• If the keyboard is going to be on a separate surface from the monitor, avoid fixed apparatuses. Consider a keyboard platform that is mounted under the work surface and can be adjusted for at least height.

• The monitor height should be so that the middle of the screen is eye level with the head positioned in neutral. The head should not have to be angled up or down to view the screen.

• If an individual wears corrective lenses with more than one visual field, the monitor should be positioned at a height that would accommodate the particular field used to view the screen. Most often, the monitor should be directly on the work surface to be low enough to avoid hyper-extending the neck.

• The monitor should be positioned in midline with the keyboard and the individual.

• The chair should be a task chair. A task chair is designed for prolonged sitting while working with the hands. A typical kitchen chair or living room chair should be avoided. The chair should have the ability to support the low back. A chair used should have some ability to adjust the height at the very least. Other possible adjustments include backrest angle, seat angle, backrest height, and seat depth. Although not all of these adjustments are needed, the chair should have some capacity to fit the body for maximum support. Armrests often get in the way so professional preference is to have a chair without arms.

• The mouse should be on the same level as the keyboard. It is not acceptable to have the mouse on top of the desk while the keyboard is on a tray. Reaching for the mouse is not acceptable. The mouse should be positioned right next to the keyboard.

• Feet should be completely supported directly on the floor or with a footrest. Fixed or adjustable footrests are available and are of individual preference for which style to use.

• The lighting should be well distributed and adequate to avoid eyestrain. Consider a mix of natural and artificial lighting.

• The monitor should be situated so that direct glare does not occur. If this does occur, reorient setup or consider a glare screen.

• If workspace is needed besides the computer setup, consider the workstation to have an L-shape design to allow for separate space with appropriate legroom available under the surface.

3. Recommended position:

• Head resting in neutral position midline with the monitor.

• Shoulders relaxed, not elevated.

• Elbows resting at the sides of the body during keyboard and mouse activity.

• Forearms should be straightforward with the wrists in neutral and fingers floating over the keys.

• Wrists should not be resting while typing.

• The back should be against the backrest and supported. No perching on the edge of the chair.

• The lower extremities should be at approximately 90-degree angles at the hips, knees and ankles.

• The feet should be supported.

4. Things to Avoid:

• Perching on the chair.

• Sitting any longer than 30 minutes without standing up.

• Having legs hang over the edge of the chair secondary to possible compression on the sciatic nerve (legs can go to sleep).

• Crossing legs while typing.

• Reaching to the keyboard.

• Working in poor lighting.

• Slouching.

HeIS Systems

 

will configure and password-protect the PC, and Internet Security for use in the coders’ homes.  Coders will supply broadband access & use secure grid cards to access the network via the web portal through the home page, or VPN connection.

 

Internet outages do occasionally occur, and in this event it is the coder’s responsibility to work with their ISP (Internet Service Provider) on a resolution. HeIS Systems will provide support of applications running on any Citrix server which is providing access to 3M.

 

Any PC related problems will require bringing the PC to HeIS Systems after scheduling maintenance with either the systems manager or the responsible database analyst.  Some technical issues may not be resolved, and at the discretion of the HeIS Systems Manager the remote coder may be required to work in-house on a short or long term basis.

 

Protocol for logging Help desk tickets:

• The remote coder must have an available phone line to speak with technical support.

• Before contacting the Help desk, the remote coder will reboot their PC.

• Coder will log system issues with the Help desk

• If a remote coder has not heard back after 30 minutes and is unable to work, the coder should request that the Help desk page the appropriate technical support.

• If after an additional 15 minutes the remote coder has not received a call back, they will call the coding manager who will in turn contact the Help desk for further assistance.

Signatures

The employee and the manager will sign the memorandum of understanding. By signing this memorandum, I acknowledge its existence and understand it does not represent a contract of employment and agree to its terms.

_______________________________________

Health Information Coders Date

________________________________________

Coding Manager Date

 

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