Leadership Skills

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We’ve all read about, attended workshops on, or studied what makes a great leader.  Well, I had experiences with a bad leader that helped me to become a great leader.

I found a quote from the late Charles S. Lauer that summarizes for me, the contrast between good and bad leaders.  “Leaders don’t force people to follow – they invite them on a journey.”

Years ago, as a coder, I witnessed the downward spiral of a coding team because of the poor leadership skills of their Manager.

Each team member possessed expert level skills and was a “top pick” from the industry.  Each one had valuable knowledge and experience to contribute to the success of not just the team, but the entire organization.

Gradually, we stopped working as a team, we lost trust in and respect for each other, and we always complained about our jobs.  Some of us resigned and became managers later in our careers.

These examples are from actual team meetings.

• The manager presented an issue and then asked the team for opinions. When members voice opinions, we were told we shouldn’t feel or think a particular way.  One of the team members would actually apologize for expressing a view that was contrary to what the manager thought she should think.
• The manager administered personality quizzes, reviewed the responses, and discussed what she perceived as each individual’s flaws and what each was required to do to correct the deficiencies.
• The manager discussed personal issues, thoughts, and observations. The entire meeting would be “I,” “me,” and “my.”  She discussed her previous vacation, her upcoming vacation, her new hand lotion, her demanding workload, and her health issues.
• The manager assigned additional work with deadlines. Each coder was already performing a full workload with quality standards and deadlines.  We were not given opportunities to discuss impediments or even ask a question.  This manager was not hands-on.  She was not a coder, and she did not understand the work-flow.
• The manager confronted individuals with accusations and complaints made by fellow team members in the team meeting. The team had deteriorated entirely, and some of the members were in “survival” mode.  They wanted to be on the manager’s good side, and they would make up issues to cause conflict.

Each one of these can harm morale.  Imagine having one on top of the other thrown at the team!

When I became a Coding Manager, I did everything opposite of this Manager, and I’ve remained that way as a Director and as a business owner.

 

There are no shortcuts

 

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I had a colleague who was also a friend.  She called me and asked my opinion.  She wanted to sit for another certification because she felt that it would accelerate her career.  I’m all for multiple certifications as long as you’re not a “jack of all trades, but master of none.”

In all of the years I’d known and worked with her, she had only coded pro-fee.  I asked her if she felt comfortable in that new arena, and she said she was.

She lived in another state, but she planned to fly to my state to sit for the exam.  She explained that she had a friend who was proctoring an exam.  She would stay with her and take the exam over the weekend at her home.  Didn’t sound right to me, and I voiced my concerns.  Fast forward, she passed the exam.

Years later, I was working on a contract, and I was talking to one of the other coders.  We were sharing our backgrounds, and she told me that she proctored exams.  She asked if I was interested in more certifications.  I told her that I was too busy to study for another exam.  She told me that was not a problem and she shared a story with me about a friend who flew into town, stayed with her over the weekend and took the exam at her home.

 

Small world, you never know who knows who.

By the way, this “proctor” is no longer in the medical coding industry.

Rogue Physician

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I received a call from the chief of a large group practice.  One of his physicians was audited by the state’s Medicaid program, and they received a demand letter for refunds.  The chief asked me to review the same records and initiate appeals for the records that I disagreed with the state’s findings.

This provider was not part of the audits that I previously performed for this group because he was unwilling to pay his portion to have his audit done.

Interestingly enough, this was the same provider who was not agreeable to paying me to do an audit for him a few years prior.  I had received a call from a colleague who owned a billing company.  She had a physician who needed an audit and coding education.  She gave me his contact information, and I reached out to him.  We discussed the concerns, and I quoted a price.  I told him I would email the contract and business associate agreement, but he did not want to sign a contract.  He told me he would reimburse my travel expenses if I would come in and review his documentation, and then we could discuss payment.  I declined.

Fast forward, this physician joined the group practice that I was working with, he was unwilling to pay his share to have an audit done for the group, and he was in trouble with Medicaid.

I reviewed the same records that Medicaid failed and agreed with the state’s findings.  I discussed the documentation issues with the physician, and he disagreed with my findings.  He refused to accept that he could not charge an office visit when patients come in for previously scheduled procedures.  He was not documenting separate/significant evaluation and management services to support the E/M codes.

I gave him a copy of my findings and recommendations and ended the session.  I forwarded a copy to the chief of the practice and followed up with a phone call.   I told him this provider was a liability to the practice.

This rogue provider caused a lot of financial issues for the group.  It was like dominoes falling.  First Medicaid, then Medicare, and then other payers were requesting refunds.  He ultimately was removed from the group.