WORK BREAKDOWN

STRUCTURE

HIA 406 TEAM I- MICHELE HORNICK & LAVATUS WINDOM

TEAM PROBLEM II

Proper coding is important to a facility as well as a patient. It helps healthcare

facilities gain revenue and it assist third party payers in rendering proper payment. Also,
it prevents patients from receiving incorrect bills. That is why it is imperative that
coders are properly trained in the American Association ICD 10 Official Guidelines to
ensure claims are not denied due to not understanding the differences in diseases and
their treatments. The beginning of this process lies in proper documentation. The
documentation has to match the exact codes that are used. If claims are denied it can
result in the loss of significant funds for health care organizations, and the health care
organization will fall out of the guidelines of CMS.

That is why it is important that our department must query the documentation
process in order to achieve accuracy. This process will assist the HIM Director, CDI
specialist and coding staff in their efforts to improve the clinical documentation
programs for outpatients. In order to achieve success in improving clinical
documentation, Learning Team I has been hired as consultants by the healthcare
organization. We are tasked with creating a power point that will include the purpose of
engagement, scope of the project, general overview of the physician documentation
query process and project deliverables. We also will write policies and procedure that
outline physician documentation query process that are supported by official coding
guidelines. Also included in our presentation we will design an outpatient physician
query form that will be adopted into the process. In order to achieve a well thought out
presentation, the workload will be broken down week by week and each member will
rotate roles in order to prevent members from burn out and also to share ideas.

Task Description Team Members Roles and

Responsibilities
Week 2 Deliverable Team Leader/Researcher: Lavatus
Windom
1. Complete WBS and submit
 Quality Assurance: Michele Hornick

Week 3 Deliverable Team Leader/Researcher: Michele

Hornick

Quality Assurance: Lavatus Windom

1. Crate and submit a PowerPoint
presentation as described above.

Week 4 Deliverable Team Leader/Researcher: Lavatus

Windom
1. Submit outlines of the policy and
procedure and query forms.
Quality Assurance: Michele Hornick

Week 5 Deliverable Team Leader/Researcher: Michele

Hornick
1. Draft the project documents
and submit.
Quality Assurance: Lavatus Windom

Final Deliverable During this week each member will work

together in order to complete the final
1. Prepare the final project deliverable.
documents for the HIM
Director.

2. Submit your final project.

Evaluation and Lessons Learned
1. Review, evaluate and comment
team presentation
2. Prepare a brief critique of our own
project
Each member will evaluate their own
performance as well as the other
members and voice their opinion on how
well the team functioned together as a
whole when completing deliverables.

Lessons Learned: How to function as a

group with changes and still complete
deliverables.
 The responsibility of the team leader is to facilitate discussions and keep the rest of
the team motivated until completion and also submit final work. The researcher will
seek out information through various sources to provide the team with input. The
quality assurance role is responsible for making sure that the weekly problem is
completed according to instruction.