# Sending coders to work remotely



## hoierj (Sep 7, 2012)

Good afternoon,

Our office is considering sending our full-time coders to work remotely from home.  They each have achieved the 5 year coding experience mark and would like to explore the pros and cons.

Does anyone have experience with this transition or currently employ remote coders? 

We are looking for production measures and pay information.  Do you pay hourly or production and if so, how did you benchmark your production base?  What production measures do you have in place?

Also, if you have any specific events, positive or negative, that you'd like to share, we would really appreciate the feedback!!

Thank you!


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## consultingbykristin (Sep 13, 2012)

I've worked remotely before and it's great.  There are a lot of benefits for both employee and employer.

To track the employee is working their hours, do you require the employee is still working an 8-5 type shift or are they allowed to complete their 8 hours any way they like over the day.  And how are those hours going to be tracked internally?  Will they log into a system remotely that can track hours for verification?  That's a big item because all to often people think no one knows if they are working or not and they fudge on time.

Another issue in productivity is looking at how many cases they code now.  They should be able to code the same number and most likely more as they don't have the same distractions at work they do at home.  On the other hand...there are always more distractions working from home and not everyone is a good candidate for remote work.  An internal method of tracking the number of cases per day should also be put into place.

If you are paying hourly now...probably the smoothest transition is to continue that structure provided you can track hours and productivity and don't have to rely on the honor system.  The benchmarking could also be the same as you would have for an onsite coder.  

Of course their systems need to be safe, HIPAA regulations need to be met, any work they have access to needs to be protected.  They should have designated work space not the kitchen table.

In what I've done, I have an entire room set up as an office.  I can come in, close the door and work.  There is no TV in this room as it's my office.  I have a radio to listen too if I need sound.  I am completely self contained with printers, computers, fax machine, scanner.  

Another good option is a weekly meeting or at least one day a week at the office.  That way any additional discussions that are needed about ongoing projects, questions, clarification, etc can still take place.  

Probably the biggest obstacle is that NOT everyone is able to handle remote work.  Some people cannot stay focused and get the job done.  Especially if the employee is allowed to set their own hours, then you have people who go off in the middle of the day and run errands or watch TV, spend time with friends, whatever the case may be and just end up not being able to complete the 8 hours.  If the employee can't stay focused and on task while working onsite, it only gets worse when trying to work from home.  It was a hard transition for me at first...but having a set office helps. I also have personal responsibility though too and that helps.  But having to check in and knowing time is somehow measured on the other side (i.e. remote log ins) helps keep everyone on track.


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## j-fowler57 (Sep 13, 2012)

LOVE LOVE LOVE the info!!! I am trying to get our office to let us do remote coding. I have done a lot of research on this and you just validated a lot of my findings. I covered the space issue, set hrs, pay, once a week meetings to stay in touch, private work area, decrease cost of office supplies, weather related call ins(all of us drive at least 40 - 60 minutes away), sick call ins, increased productivity, and yes not everyone is meant to work from home. They may think they can but then they are more easily distracted at home. 
 The one question is computers.... does the company provide your computer and all the updates needed thru their IS or IT dept? That is the one question still hanging out there for some reason. Just would like some feedback on that aspect.
If you don't mind I will copy/paste this in an email to my director to help my cause.
Thanks!!!!!!!


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## hoierj (Sep 14, 2012)

Thank you for the info!  

We have addressed all those issues as well.  We currently are allowed to work from home if the roads are dangerous in the winter, but using our own equipment.
Over the past year, I was given 2 laptops that our providers weren't using.  These would then be our workstations at home and it works really well for security purposes (work only) and our IT department still has to support hardware and software and upgrades are free.  The only caveat was no printing from home due for security reasons, so we have designed an "in-office coder" schedule where 1 of us is present in the office for all paper matters and phone matters (appeals.)  The remote coders on that day are then concentrating on the charge review aspect.
Productivity is measured through the charge review workques and our days to post reports.
My COO was questioning whether it was industry standard to pay on production or hourly.  We would then have to design an in office salary and a remote production base, but we code everything from surgeries to E/M's, procedures, imaging, etc, so it seems rather overwhelming at this point and was trying to see what others had done.  We are employed by the provider and not contract workers, which is really the only noticable difference in whether it's hourly or production from what I've read online so far.

Thanks for all your feedback!!


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## hoierj (Sep 14, 2012)

Also, currently we use an online payroll system, where breaks/lunch/in/out can be seen on a pin board.  

Hours would vary, but I would prefer to stick with an uninterrupted 8 hour shift.  The policy now is anything over 1 hour requires using PTO hours.  I feel that should stay the same.  I don't mind shifting the hours worked as far as starting earlier or later.  We still have to be available for all staff by instant messaging and Outlook during office hours, so I don't feel that interrupting a shift would be beneficial for the rest of the staff.


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## j-fowler57 (Sep 15, 2012)

I work in a hospital so was wondering how they would do the computer? Does the hospital provide one or do we? Was wondering what the majority does.

Most people I have talked with, the hospital has provided and their IT dept is required to do any and all the updates needed. 



 Any feedback is appreciated


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## hoierj (Sep 19, 2012)

*Hospital*

The hospital we are affiliated with recently sent their coders home.  Basically, handed them their desktop computers they use everyday and sent them home.

They essentiall took their entire desk home, minus printers of course, for security reasons.

This way, the hospital IT staff still has to support the equipment and programs.

We share the same server since we are on the same EHR, our laptops would then be serviced by the IT as well, since we purchased from them, and they own the servers.

We are given a remote access website and login to secure servers for HIPAA and IT has to grant remote access from their side, which is some paperwork and security check.

Hope this helps.


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## kevbshields (Sep 19, 2012)

Do any of you recognize that the convenience you afford yourselves creates several issues industry-wide?

By moving pay to production, the focus is taken off quality.  While you might try and argue that accuracy will still be measured, eventually it will be difficult for some of your staff to maintain that quality when they become preoocupied with meeting "quota" or with getting their day's worth of work ($).  I've worked on productivity at home, I know the pressure those workers feel to keep up their standard of living while balancing that against quality.  It's a tough choice.

Related to that, despite all the success stories about how nice it is to work remotely, keep in mind that paying on productivity eventually becomes an invitation to reduce salary.  If you doubt this, have a look at what happened with transcription salaries when those were moved to production basis--after we sent them home.  Not pretty.

Secondly, by going home you are inviting outsourcing upon yourself and your colleagues.  Eventually the providers and office staff "forget" about the importance of having your particular staff on the payroll.  You minimize your visibility by going home and being rarely seen.  Remote coders make it look easy to be replaced, and some practices have done so, just like transcription.  There are practice administrators, owning physicians and others who find, after awhile, that it makes less sense to pay your health benefits when they can outsource somewhere else and not have that financial burden.  They will not understand the quality implications until you are long gone.

Although working at home is a terrific approach when road conditions are messy, you aren't feeling your best or have to take "light duty," when gas prices skyrocket or similar situations, but in the long wrong you're helping to kill the profession from the inside out.  I know that may be hard to accept, but it is my observation and opinion.


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## theresa.dix@tennova.com (Sep 20, 2012)

kevbshields said:


> Do any of you recognize that the convenience you afford yourselves creates several issues industry-wide?
> 
> By moving pay to production, the focus is taken off quality.  While you might try and argue that accuracy will still be measured, eventually it will be difficult for some of your staff to maintain that quality when they become preoocupied with meeting "quota" or with getting their day's worth of work ($).  I've worked on productivity at home, I know the pressure those workers feel to keep up their standard of living while balancing that against quality.  It's a tough choice.
> 
> ...



Kevin,
 This is exactly why I have not pushed working from home to my supervisor. Out of site out of mind.


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## skh_fla (Sep 20, 2012)

*working from home*

Hi, I have worked completely remotely for over three years and love it.  There are some issues to deal with - making sure that everything is communicated to everyone (we use email a lot and our meetings have call in numbers to help us deal with that.)  Also, you can feel a little cut off if you are home every day, and there is little room for advancement in my company, since I'm 100% off site (I am 1500 miles from the main company.)  

Not everyone likes to work from home - I am much more productive but it certainly isn't for everyone.  We submit sheets at the end of each day indicating what has been accomplished and how much time was spent to help our supervisor make sure everything gets done.  We also have an assignment "calendar" to track who is responsible for which duties on which days.  We work specific shifts, like 7 - 3, although there is some flexibility.

I supply my own computer (I'm able to use my personal computer because I can access work through a web portal) and phone, but the company uses a "virtual phone" application that links to whatever line I would like to use.  Currently I use a cell phone, but I could change that to a land line if I wanted.  Calls are not forwarded to it unless the application is running, so there is no fear of calls coming in day and night.

It can certainly be done in every situation but it's a give and take on both sides - working together is key.  Making sure the business has what it needs and the employee is supported will make it much more successful.


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## hoierj (Sep 20, 2012)

I appreciate the feedback.  I do not support production and reducing this job to counting widgets.  I hold myself to a higher standard personally and professionally.  I am smart enough to do the math.

I also have open dialog with our COO, whereby I expressed my concern regarding out of site of mind mentality. I didn't just walk in there and throw the question out there.  I did my due diligence in reading and preparing myself in both the pros and cons from my perspective and his.

I did not appreciate the reference that my selfish endeavors and personal preference are ruining the entire profession as a whole.  1st and foremost I have a career to succeed at, whereby, posting a general question in a general topic forum does not make it personal.

Thanks to everyone  that had constructive, not destructive, feedback.


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## j-fowler57 (Sep 24, 2012)

hoierj said:


> I appreciate the feedback.  I do not support production and reducing this job to counting widgets.  I hold myself to a higher standard personally and professionally.  I am smart enough to do the math.
> 
> I also have open dialog with our COO, whereby I expressed my concern regarding out of site of mind mentality. I didn't just walk in there and throw the question out there.  I did my due diligence in reading and preparing myself in both the pros and cons from my perspective and his.
> 
> ...



I agree hoierj. I also have not went into this blindly. And my boss is one who does not just jump into things lightly. This is something that my hospital has been considering for several years and is now becoming more of a reality. Every other hospital in the area is doing this. All I was basically asking was for info on how they do the computers. This seems to be the issue at hand with us at this time. I have went and researched other hospitals in my area to see what is what... pros and cons. 
And I agree not everyone can work from home and be productive. But I know I can. We all live in a very rural area and it is sometimes difficult for us to get to work. My employer seems this as an opportunity for us to be productive in the aspect that sometimes we just can't get here weather related and if we work from home we can still be productive and they aren't losing anything and neither are we. 
My employer has looked at "productivity" vs hrly and we aren't losing anything. We all know what is expected of us as workers either in professional setting or home setting. We all have the same objective at hand and that is to do the best we can. Nothing changes. Except my location. We know that they could come back and say no it's not going to work so that is why we ( coders ) will continue to strive to do the best we can if not more. 
I take my job and profession very serious and to me this is a "plus" for my employer to offer to us. 
I appreciate everyones comments but truly don't feel I'm hurting the profession by being allowed to do this. And if I'm misinterpreting it wrong then I apologize.
Thank you everyone for your comments.


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## j-fowler57 (Sep 24, 2012)

And.... we also are going to be coming into the hospital at least 1 -2 days per week to work so we're not completely out of site out of mind. The MAIN reason our hospital is deciding to this is space issues. So it will take 3 work stations down to just the need of one and free up space for other things needed. 
Thanks


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## hoierj (Sep 28, 2012)

j-fowler57 said:


> I agree hoierj. I also have not went into this blindly. And my boss is one who does not just jump into things lightly. This is something that my hospital has been considering for several years and is now becoming more of a reality. Every other hospital in the area is doing this. All I was basically asking was for info on how they do the computers. This seems to be the issue at hand with us at this time. I have went and researched other hospitals in my area to see what is what... pros and cons.
> And I agree not everyone can work from home and be productive. But I know I can. We all live in a very rural area and it is sometimes difficult for us to get to work. My employer seems this as an opportunity for us to be productive in the aspect that sometimes we just can't get here weather related and if we work from home we can still be productive and they aren't losing anything and neither are we.
> My employer has looked at "productivity" vs hrly and we aren't losing anything. We all know what is expected of us as workers either in professional setting or home setting. We all have the same objective at hand and that is to do the best we can. Nothing changes. Except my location. We know that they could come back and say no it's not going to work so that is why we ( coders ) will continue to strive to do the best we can if not more.
> I take my job and profession very serious and to me this is a "plus" for my employer to offer to us.
> ...





Well said!!  My thoughts exactly.  Good luck in your endeavors.  I don't feel I'm hurting the professon either,I have integrity.  By proving I'm flexible, professional, AND AMENABLE TO CHANGE, my employers put a check mark in my, "She's an asset to the company" column.  Working from home 1 or 2 days a week is a reward for the hard work.


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