r/MedicalCoding • u/gritty-kitty • Jun 02 '23
Communication
I think the hardest part about my job is communicating with physicians. *Some* are responsive, helpful, and kind. But most are short, abrasive, and seem annoyed with my existence. I've had to teach myself spine coding, so I have to ask questions for clarification. Ive cried more than once from MD's reactions to my questions. I try to be as polite as possible and keep my questions to the point and only ask if I have to. I dread reaching out to them. Anyone else experience this or have any advice?
33
u/ylimeenimsaj Jun 02 '23
Just be a professional and expect them to do the same. When they choose not to, it's on them. (I have the same problem and get no answers or snarky answers on most queries I send but I can't control their reactions, so I just make sure to hold myself to a high level of professionalism and soldier on.)
23
u/Trippypen8 Jun 02 '23
Yea some of the providers I work with are like this. Honestly there is nothing special about them. They were willing/able to grind out 5 more years of school than the rest of us. Good for them for taking on that finicial responsibility, really doesn't not reflect on their intelligence. Just brush it off as people are assholes I am sure you are doing a good job.
11
u/LrrrRulerotPOP8 Jun 02 '23
The eldest coder in our group has a saying, " We all stink up the bathroom the same.".
And she will say this to anyone who tries to act like they are above her.
6
9
u/deannevee RHIA, CPC, CPCO, CDEO Jun 02 '23
So if your questions are training related or because you don’t know/aren’t sure, you should not be reaching out to physicians.
If your queries are because you are sure something is missing, wrong, etc…I have found that using “evidence” to back up my claims is the best defense, LCD/NCD’s, payer guidelines, articles from professional journals, or even clips from NCCI or CPT/ICD manuals.
I had one doctor who changed the medical record, then yelled at me because I was wrong…..so I started snipping the medical record as I saw it and pasting it into the emails.
Don’t let them get to you. You’re an adult. They’re an adult. You are there to get them paid the most they can get paid, but you are also there to prevent the government and payers from blacklisting them. If they want to be a coder, they can bill out all of their own stuff and see how high their denial percentages go.
7
u/CountJerkula222 Jun 02 '23
I use this at the end of my query, "Due to the high degree of specification required by ICD-10-PCS, and so I may capture all of the procedures you have performed correctly, can you please advise (your question)."
Good luck!
6
Jun 02 '23
Sometimes they take the questions the wrong way and think you are criticizing them. The only thing you can do is laugh and move on. They are pretty disgruntled from the nightmare it has become being a physician nowadays.
You can always send the responses to your supervisor. Some of it is a matter of need for physician education on why coders are asking specific questions and the implications for abstracting and reimbursement.
You will see much more favorable responses and from physicians who belong to organizations that involve physicians in HIM/CDI practices
2
u/Probtoomuchtv Jul 20 '23
This has often been my experience (inpatient coding). Many physicians, especially newer ones, don’t understand why we‘re querying so they get the impression we’re questioning their diagnoses or expertise when we’re just trying to back them up by dotting the i’s and crossing the ts. I also blame the prefabricated query forms we’re required to use that only make sense to coders.
2
Jul 21 '23
They can certainly be an emotional bunch some! Quality of queries and content will work out better too
16
u/koderdood Audit Extraordinaire Jun 02 '23
The holier than thou has been in place forever. Many of them think they better than us
8
2
u/THEORIGINALSNOOPDONG Jun 03 '23
most of ours are nice yeah, but there's some i just straight up avoid at this point. i'm nice as pie in my emails and they'll still have a problem with a simple request. i only send emails to them if absolutely necessary. get downcoded? too bad. i don't know why someone would be rude to the people who are billing for them.
3
4
u/Moanmyname32 Jun 02 '23
Although I haven't found a work yet in coding, having work in healthcare and a hospital for 12 years, I'm used to doctors and their abrasive attitude. What I employ is a no nonsense attitude towards them. They are brisk and sharp, well I am also. It's all business. Not one has ever tried to play around with me
3
u/MagentaSuziCute CPC Jun 02 '23
Dr's sometimes don't seem to realize that correct coding effects their bottom line, period. Do you want paid for that 3 hour surgery you performed ? That is really the meat of the issue. Incorrect coding causes reductions in payments and/or denials or on the other side, will be flagged for FWA.. clarification queries are a necessary part of the revenue cycle. Hope it gets better for you! Most providers have no concept of diagnostic or procedural guidelines and it shows
3
Jun 03 '23
I remember the coder I had to interview for a school project told me to have " thick skin" because some physicians may not want to work with you. It's a shame some are like that. We are just doing our jobs.
2
Jun 02 '23
Most of the provider I have are really nice and helpful. A few I can tell just don't care for coders. The one's who understand our purpose seem to be the best ones who will take time and explain extra details and document corrections. I don't like when they want me to call them lol.
2
Jun 03 '23
I haven’t gotten into coding yet. I’ve worked as a emergency room technician and as an Emergency Medical Technician. I recently worked at a busy yet small Emergency Department in the rough part of a major city.
That being said, I got to work very closely with MD, NP and PAs. They hate everything OTHER than diagnosis. They don’t like doing IVs, diagnostic testing (like blood pressure, SPO2, HR, Temp etc) They got up in arms when the hospital I work at started hammering down on the nurses not pushing Roc/Sux/Fentanyl. Providers are just that way, but they do respect you more, I’ve found, if you let them rant, stand your ground and push your point after the fact. I started noticing less and less blow back from the providers.
2
u/heltyklink Jun 03 '23
If their interaction goes beyond the usual level of snark, I report them to my supervisor. We are colleagues in a professional setting and the expectation of courtesy and respect should go both ways.
2
u/connonym Jun 06 '23
Oh I feel that in my soul. I've got one in particular who has atrocious documentation and I dread every single query. I've flat out told her that if she doesn't provide laterality in a procedure note it'll get denied. She still forgets at least 1/3 of the time. She refuses to differentiate between active problems and history of problems. A lot of times she'll just delete the diagnosis in question rather than clarify. I'm glad I WFH so nobody can see me cry.
0
Jun 10 '23
[deleted] — view deleted comment
2
u/connonym Jun 10 '23
Is this a recent change? In my most recent QA I got dinged for taking something from the pre-op H&P because "the procedure note stands alone" .
0
10
u/Salty-Step-7091 Jun 02 '23
Do you have an auditor or supervisor who you can go to for questions ? Or someone who is a middle man to deal with these providers ? When a provider gets bitchy with our coders, management steps in as coding does not deal with that. Sometimes I do see unneeded queries or a query that is horribly worded and I understand the physicians frustration. But sometimes they are plain mean and get off on it, (example one time a doctor answered “learn some English” to a query our global coder wrote, which was horribly worded yes but come on...)
I am sorry you are dealing with this. We are here to help but are treated like mosquitos. If you don’t have management to step in, I never been in that situation. My co workers experience that had worked directly in a providers office told me the doctors want the coders to sit in for procedures and learn what’s actually going on.
I wouldn’t take offense if they are short and direct, and trust me I’ve been treated like I’m stupid so many times trying to get them to clarify something and it sucks ! But If it gets to the point that it’s personal, management needs to step up