38%

decreased DNFC days

13%

decreased complex denials

30%

decrease in rejected claims

Richmond University Medical Center (RUMC) is an affiliate of The Mount Sinai Hospital and Mount Sinai School of Medicine on Manhattan. A 470+ bed healthcare facility, RUMC serves New York City borough residents as a leader in the areas of surgery, gastroenterology, pediatrics and pediatric gastroenterology, endocrinology, urology, oncology, orthopedics, surgery and maternal health.

Challenge

RUMC felt that their existing encoder vendor was not going to be able to offer all of the workflow and functionality that was about to be required with the - at that time - pending ICD-10 migration, on October 1, 2015. Another objective was to cut-down on the time for coders to code cases. The immediate concern was proactively combating the forecasted productivity losses that would impact RUMC coders with the change-over to ICD-10, which would negatively impact DNFB and hospital cash flow.

Solution

In spite of hospitals experiencing anywhere between 10% - 50% loss in coder productivity with the ICD-10 transition, RUMC has actually realized a 33% increase in coder productivity since October 1, 2016. Organizational metrics, like DNFB and CMI, were not negatively impacted by the ICD-10 cut-over and Discharged Not Final Coded (DNFC) is never more than three days.