An HIM professional works as a health data analyst at a medical practice. While analyzing coding...

 

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An HIM professional works as a health data analyst at a medical practice. While analyzing coding productivity and reimbursement rates for the practice, the HIM professional notices a concerning trend in one specific coder's productivity and outcomes. Although this coder has low productivity (number of charts coded), their reimbursement rates are much higher than those of the other coders despite similar patient acuity (severity and level of care provided). It seems this coder codes fewer charts, but payments are much higher for the ones they do submit. This coder is a close friend of the HIM professional and can be somewhat sensitive to any professional criticism or challenges. The HIM professional feels torn between questioning the professional competence of their friend and the results of the analysis. 1. Define the ethical dilemma. 2. What ethical principle or issue is in question for the HIM professional? 3. Could they use any code of ethics to guide their decision? If so, which one(s)? 4. What should the HIM professional do? Using the Ethical Decision-Making Model, how did you make this decision? Activate An HIM professional works as a health data analyst at a medical practice. While analyzing coding productivity and reimbursement rates for the practice, the HIM professional notices a concerning trend in one specific coder's productivity and outcomes. Although this coder has low productivity (number of charts coded), their reimbursement rates are much higher than those of the other coders despite similar patient acuity (severity and level of care provided). It seems this coder codes fewer charts, but payments are much higher for the ones they do submit. This coder is a close friend of the HIM professional and can be somewhat sensitive to any professional criticism or challenges. The HIM professional feels torn between questioning the professional competence of their friend and the results of the analysis. 1. Define the ethical dilemma. 2. What ethical principle or issue is in question for the HIM professional? 3. Could they use any code of ethics to guide their decision? If so, which one(s)? 4. What should the HIM professional do? Using the Ethical Decision-Making Model, how did you make this decision? Activate