Professionalism & Ethics - Complete · Integrity, Ethics and Professionalism •Ethical standards exist in every profession. Integrity is a key element of what every profession considers

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Professionalism & EthicsPresented by

Ashley Yawn, BS, CPC

What is Professionalism?

• The Merriam‐Webster dictionary defines professionalism as "the conduct, aims, or qualities that characterize or mark a profession or a professional person;" and it defines a profession as "a calling requiring specialized knowledge and often long and intensive academic preparation."

• These definitions imply that professionalism encompasses a number of different attributes, and,together, these attributes identify and define a professional:

• Specialized Knowledge (Medical Coding)

• The key factor’s in AAPC’s Code of Ethics

• Looking the Part / Dressing for Success

Acts of Professionalism

• Attending to the details of your job demonstrates commitment to the workplace culture.

• Being punctual and prepared when at work

• Respecting workplace property and policies

• Attending meetings when expected

• Respecting office rules regarding such things as dress code, personal phone use or office romances

• Too many breeches of workplace basics can undermine your credibility. Instead, go beyond the basics by putting in extra hours, taking up others’ slack and going above and beyond.

Professionalism & Ethics

Coding Fiesta 2019 Ashley Yawn, BS, CPC October 26, 2019

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Professionalism vs Ethics?

Ethics refers to the guidelines that state the dos and don'ts in a specific context whereas professionalism refers to the specific traits that are expected of a professional. Ethics are usually stated whereas professionalism is cultivated by the individual personally.

Traits vs Guidelines

AAPC Code of Ethics

• It shall be the responsibility of every AAPC member, as a condition of continued membership, to conduct themselves in all professional activities in a manner consistent with ALL of the following ethical principles of professional conduct:

• Integrity

• Respect

• Commitment

• Competence

• Fairness

• Responsibility

• Adherence to these ethical standards assists in assuring public confidence in the integrity and professionalism of AAPC members. Failure to conform professional conduct to these ethical standards, as determined by AAPC's Ethics Committee, may result in the loss of membership with AAPC.

‐https://www.aapc.com/aboutus/code‐of‐ethics.aspx

Integrity

• Defined by Merriam‐Webster as : firm adherence to a code of especially moral or artistic values : INCORRUPTIBILITY

• People with integrity are honest and trustworthy, build effective interpersonal relationships with coworkers and are characterized by their willingness to do what is right, even when no one is watching or monitoring their performance.

• It is important to note that no matter how big or small the situation is, employees can demonstrate their integrity—or lack of it—every single day.



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Examples of Integrity in the Workplace

• An employee used up the last bit of toilet paper in her bathroom stall. Rather than leave the dispenser empty for the next employee, she located the refills of toilet paper and replaced the roll. It may have taken her a few minutes, but she didn’t leave the next employee in a bad situation.

• An employee missed a deadline for an important assignment his team was supposed to have coded. Rather than throwing his team members under the bus, even though they hadn’t delivered as promised, he took responsibility for the missed deadline. He addressed the problems with his team, and they put in place safeguards that would keep them from underperforming again.

Team members recognized their contribution to the failure but there were no repercussions because the “slacking” employee took responsibility as the team leader and they developed a plan of action to ensure it would not occur again.

Do You Act with Integrity?

While on the clock at work, do you work diligently as your

employer would expect, or do you take time out to conduct personal business? Employers expect employees to work the hours for which they are being compensated. Employees are not paid to socialize, surf the Internet, pay bills, update their

Facebook status, etc. An employee with integrity will provide the level of effort his or her employer is paying for and will self‐regulate work behavior. Employees acting with integrity resist the

temptation to engage in non‐work‐related activities.

Do you cut corners and neglect workplace regulations? In healthcare, ignoring policies

can lead to mistakes, noncompliance, and potentially life‐threatening situations for patients. Taking shortcuts or seeking the easiest way to get through the day does not

reflect a person with integrity.

Do you treat co‐workers with respect? A person with

integrity looks beyond his or her own interests and pursues team‐centered goals. This

requires polite and professional communication, appropriate interactions, and respect for the thoughts and opinions of co‐workers. When

disagreements arise (on coding, for example), do you objectively consider the

position of your peers? Are you willing to be proved wrong? If

the position of the other person is wrong, do you use

the situation as an opportunity to educate or ridicule?

AAPC’s Take: Integrity, Ethics and Professionalism

• Ethical standards exist in every profession. Integrity is a key element of what every profession considers appropriate ethical behavior. In professional and/or business relationships, integrity is a much sought after trait. Certainly no physician would hire a coder lacking integrity, just as no patient would likely choose a physician lacking integrity. Similarly, coders appreciate working with co‐workers and for employers who exhibit integrity.

• Although it is not difficult to understand the importance of integrity in business relationships (as well as personal ones), it is sometimes difficult to determine what integrity actually is. Honesty, truthfulness, honor, dependability, and trustworthiness are all traits of those with integrity; as is upholding a moral standard of conduct in both professional and personal endeavors. Standards governing professional conduct include knowing how you present yourself, your work ethic, and how you communicate with others.

• Integrity requires strong moral principles: good character, honor, and honesty. Honesty is fairly cut and dry, but "good character" and "honor" are more obtuse qualities.



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Respect

• Oxford dictionary defined as:

• a feeling of deep admiration for someone or something elicited by their abilities, qualities, or achievements.

• due regard for the feelings, wishes, rights, or traditions of others.

• Do unto other’s as you would have them do unto you

• Disrespect is the opposite of respect, to have no regard for other’s beliefs; by ignoring them completely, showing lack of courtesy / impolite, or just being rude.

AAPC’s Take: Respect

• The expectation of adhering to core ethical elements sets AAPC apart from other certifying organizations. These core ethical standards assist in assuring public confidence in the integrity and professionalism of AAPC members. One of the core ethical principles of professional conduct is respect.

• Respect is important in everyday life. We are taught respect from an early age. We are taught to respect our parents, teachers, siblings, and elders. We are taught to respect school rules, the feelings of others, family and cultural traditions, our country and its leaders, and the law. It is important for members to respect the right of others to express their opinions, including opinions differing from our own.

Are You Respectful?

• To assess your level of respectfulness, answer the following questions:

• Are you considerate of other people?

• Do you treat people the way you want to be treated?

• How do you react to others with different opinions?

• Do you treat people with dignity, courtesy, and civility?

• Do you strive to solve problems in a positive manner?

• Do you intentionally ridicule, embarrass, or hurt others?



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Self‐Respect

Self‐respect is the foundation of a positive direction in life. Developing and maintaining a strong sense of self‐respect can help fulfill your potential. Consistently conducting yourself in this manner will help you develop healthy relationships and will let others see you as a person worthy of respect. Respecting yourself, appreciating your own good qualities, and highlighting the positive in other people's lives will help you earn the respect of others.

Self‐respect can be, in part, demonstrated by your appearance. If you seek respect, consider putting time and effort into your appearance. You should practice good grooming habits and dress neatly. Clothes do not need to be expensive; however, they should be in good condition and laundered. Practice good hygiene and take care of your health.

How you present yourself in oral and written communication is also important. Practice good grammar and use appropriate and professional language in your verbal and written communications.

Respecting Others Respecting the rights and privacy of others as well

as the confidentiality requirements of your workplace, AAPC, or other organizations is an

important reflection of your degree of professional conduct. Ethical professionals do not violate

confidences or talk about others in a derogatory manner. Ethical people treat others with dignity.

Finally, professional coders should demonstrate respect for the credentials they hold and the

organization to which they belong. Respecting your credentials requires continuous diligence in not only

maintaining, but improving your level of professional competence. This requires meeting your continuing education requirements and

challenging yourself to go beyond the minimum standards. Respect for our organization does not prohibit criticism or the free sharing of ideas, but

does require you to do so constructively.

Commitment

• Oxford dictionary defined as:

• the state or quality of being dedicated to a cause, activity, etc.

• an engagement or obligation that restricts freedom of action.

• Bringing energy and initiative to your job every day shows commitment. Caring more about your work and your organization will show in the results you produce. Showing commitment can demonstrate your leadership potential to managers and lead to career opportunities. Additionally, an effective and dedicated manager is the most influential factor in employees’ commitment, according to a 2010 Zenger Folkman study that asked nearly 100,000 employees about why they commit to their jobs.



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Commitment in the Workplace

• Striving for customer satisfaction shows your commitment to your employer. While we may not have direct “customer” contact, we still have a customer – might it be the patient, the physician, the practice, or the insurance company. Your job plays a direct role in keeping your employer’s customer base loyal and growing.

• Being an active part in group task shows commitment to your work team. Displaying confidence in your ideas, skills and research is a trait that employer's value. Being a reliable worker shows commitment to your team’s objectives and an understanding of the part you play in a bigger picture. Taking leadership roles and organizing team members in training exercises or to cooperate with each other, shows a commitment to the achievement of the company as a whole.

• Keeping yourself and your co‐workers motivated can show your commitment to the overall challenges and demands of your business.

AAPC’s Take: Commitment

• According to the Urban Dictionary's top definition, "Commitment is what transforms the promise into reality. It is the words that speak boldly of your intentions. And the actions which speak louder than words. It is making the time when there is none. Coming through time after time after time, year after year after year. Commitment is the stuff character is made of; The power to change the face of things. It is the daily triumph of integrity over skepticism."

• Before you make a commitment, consider carefully the possible outcomes of your decision. A commitment obligates you to do something. Some commitments, like marriage, can be life altering. When you take a job, you're making a commitment to show up and do the job well — whether it is a paid position and your employer has committed to compensate you, or it's a volunteer effort.

Competence

• Defined by the Oxford dictionary as:

• the ability to do something successfully or efficiently.

• AAPC’s Core Value:

• AAPC's commitment to core values includes competence. This commitment is reflected in adopted principles for AAPC members to adhere to including, but not limited to:

• Developing and achieving a skill set that fosters high quality, effective work product, and work process;

• Maintaining credentials and coding expertise through ongoing continuing education, networking, and professional development; and

• Maintaining a strong knowledgebase of key principles, including an awareness and understanding of applicable laws and regulations surrounding ethical and competent, professional coding.



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AAPC’s Take: Competence

• Competence, as defined by Business Dictionary, is "A cluster of related abilities, commitments, knowledge, and skills that enable a person (or an organization) to act effectively in a job or situation." In medical coding, competence requires more than memorizing codes or physician office habits. Rather, it requires coders to understand the premise of professional coding, to quantify (on behalf of a provider) the cognitive interaction between a provider and patient so as to describe sufficiently the encounter to the payer for reimbursement purposes.

• Coding is the last link in the chain of the physician/patient interaction. It’s the last step that tells the payer why the patient presented for care, what happened, and when. Such a step requires a high level of trust by the physician that the coder comprehends his or her note describing the patient’s problems and treatment; and by the payer that the codes submitted for payment correlate with the provider’s documentation and the patient’s condition.

AAPC’s Ethics Committee: Competency

• Competency cannot be emphasized enough. AAPC’s Ethics Committee occasionally encounters disputes involving competency. Surprisingly, such issues rarely involve actual knowledge and skill, but instead involve member conduct, where a coder knew or should have known his or her actions deviated from generally accepted standards and practices.

• Taking shortcuts, not engaging in due diligence, failing to adhere to the "rules of the road," and engaging in inappropriate behavior can lead to review before the AAPC Ethics Committee panel. For example, coders should question circumstances where quantity of claims processed is more important than ensuring the codes on the claims are correct.

• The coding profession’s role in healthcare will assume increasing importance with the transition to ICD‐10 and shift from fee‐for‐service to value‐based compensation. Such importance is reflected by the increased discussion surrounding these transformative changes.

• AAPC seeks to ensure that its membership reflects the very best of competent and trustworthy professionals who can be relied on to help physicians and other providers be properly compensated for their services. The AAPC Code of Ethics should serve as a road map to all who help navigate the business of healthcare.

Fairness

• Fairness is defined by the Oxford Dictionary as:

• impartial and just treatment or behavior without favoritism or discrimination.

• While workplace fairness, as well as managerial fairness are key aspects to a positive workplace environment, we will look at what AAPC considers Fairness as an employee and an AAPC member.



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AAPC’s Take: FairnessBy Christopher A.

Parrella, JD, CHC, CPC, CPCO

• As members of AAPC, you are ethically and professionally responsible for treating co‐workers, employers, and colleagues fairly, as well as obligated to foster an environment of fairness whether it be at work, a chapter meeting, or other professional event. The principle of fairness requires impartiality, honesty, and the disclosure of material conflicts of interest. A conflict of interest generally occurs when you're in a position to influence a decision on behalf of a particular party when your decision, more likely than not, will affect another party to whom you have a corresponding and competing loyalty.

• Fairness generally involves a total disregard of personal feelings, prejudices, and desires to attain a proper balance of conflicting interests. Fairness is treating others in the same fashion you want to be treated. Fairness is at the core of all professional engagements. It's very likely that the person seeking your professional services has substantially less knowledge and training in the area of coding than yourself. You bring your knowledge and training as a healthcare business professional to establish a relationship of trust to deliver services and advice to the client. You are responsible to ensure an environment of inclusiveness and a commitment to diversity in the organization you serve.

AAPC’s Take: Fairness (Cont.)

• As AAPC members, you are given the responsibility of developing, administering, and advocating policies and procedures that foster fair, consistent, and equitable treatment for all. Regardless of your personal interests, you are obligated to support and foster a corporate culture made of decisions by your organization that are both ethical and legal. It is your ethical duty to conduct yourself in a manner that equalizes your self‐interests with the interests of others. To achieve this goal, you must always act impartially and objectively. When you consider each statement or action from the perspective of those on the receiving side, choosing the correct approach becomes more readily apparent.

Responsibility

• Oxford Dictionary defines as:

• the state or fact of having a duty to deal with something or of having control over someone.

• the state or fact of being accountable or to blame for something.

• the opportunity or ability to act independently and make decisions without authorization.

• Responsibility in the workplace is required in many areas as a medical coder; your personal job duties, corporate SOPs, HIPAA Compliance, etc. All of them are slightly different, but they all center around you knowing and following guidelines and being accountable for your actions. Responsible workers are more engaged and hold themselves accountable to deliver results.



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AAPC’s Take: Responsibility

• As healthcare business professionals, we have many things for which we are responsible, which is to say, things within our control for which we are answerable or accountable. As AAPC members, we are accountable for our own professional conduct, and by living up to this obligation, we contribute to the success of our organization and our profession. We have an obligation to ensure the conduct of our colleagues is consistent with professional standards. The perception the healthcare industry has for AAPC and its members is in no small part based on the degree of professionalism we individually and collectively exhibit. It is for this reason that AAPC members are expected to uphold to ethical standards. Responsibility is a core principle in the AAPC Code of Ethics. It requires conformance with all other elements of the Code and requires every member to assist in the enforcement of the Code of Ethics.

• While some think of responsibility in terms of blame (e.g., "Who is responsible for this?"), a more positive connotation is to think of responsibility in terms of opportunity. It is what allows us to exert choice and take control. A more practical definition of responsibility is the willingness to respond appropriately, regardless of the situation or the impact of doing so. Create the outcome you want through personal choices while following accepted ethical and moral rules; and recognize that each member is 100 percent responsible for the choices he or she makes.

AAPC’s Take: Responsibility

(Cont.)

• Being responsible means considering how your personal decisions and actions may affect others, as well as you. All professionals share the obligation of being accountable for their choices and actions. Being responsible requires knowing your limitations. As healthcare business professionals, we are responsible primarily for our own work product and our own conduct. We are responsible for being competent and knowledgeable. We are responsible for giving our employers the benefit of our knowledge and advice, even though this advice may not be followed. Ultimately, we are responsible to uphold the image of our profession. We meet this obligation by controlling our own conduct and reporting instances of misconduct by others. We are accountable in both circumstances by virtue of the AAPC Code of Ethics.

• Some may look at responsibility as a burden. A better approach is to look at it as an issue of trust. When you accept responsibility for something, others trust you will follow through. Employers seeking a healthcare professional place trust in you and your certification. Specifically, there is and must be trust that AAPC credentialed members possess all of the core values that our code of ethics demands: Integrity, Respect, Commitment, Competence, Fairness, and Responsibility. Your reputation is associated with the characteristics of other AAPC members. Acting irresponsibly results in a loss of trust and regaining that trust is difficult. Where one member violates the trust given by another, it not only damages the reputation of the individual, but of the profession. For this reason, a professional must always be a person holding themselves accountable for their actions and decisions. This is why AAPC members are required to comply with ethical obligations and why sanctions are imposed on those who do not conform to these standards.

Professional Integrity Outside the Workplace

• At a conference or chapter event, do you pay attention to the speaker and learn the concepts presented in exchange for the continuing education units (CEUs) you will claim? Competence is another important trait of professional behavior, and submittingCEUs should be based on your efforts to learn something. CEUs should not simply be an indicator of your presence at an educational event.

• An issue impacting you arises in a blog or other social media forum. Are your comments constructive and solution‐oriented, or are they purely negative? A person with integrity does not "tee off" in a public forum in a way that is disrespectful to the profession of coding, other coders, or to AAPC. Whether you disagree with an AAPC corporate decision or take issue with a forum post from another member, a person with integrity finds a way to express disagreement or dissatisfaction in a way that is not disrespectful or demeaning to others. A person with integrity also politely reminds others who have deviated from such standards that such conduct is inappropriate.

• While attending an industry conference, your registration is mixed up and you do not get in the session you expected to attend. Do you berate the conference staff or do you exhibit integrity and professionally work with the individual helping you? As a similar example, if you regularly travel by air, you have likely been subject to flight cancellations. You may have observed a traveler screaming and berating the ticket agent or staff when this happens. The irate person isn’t considering that he or she is yelling at the only person that can help, and is making the situation worse for everyone.



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“You can have anything you want in life if you dress for it.”

• ‐Edith Head, Costume Designer, Academy Award Winner

What is Dressing For Success Important

Over the last twenty to thirty years, business attire has changed dramatically; and many have forgotten the importance.

Presents a visual image and sends the message that the employees are professional, and that speaks volumes for the company.

You never know when you will meet with someone from outside of your company – networking, interviewing, securing a new physician, hiring a new quality employee, speaking with the public.

“How an individual dresses for work can be a powerful extension of his personal brand. Clothes, accessories and even the footwear an employee chooses to wear can help to reinforce or diminish his skills and qualities in the eyes of his employer, co‐workers and clients.” – Matthew Randall of the Center for Professional Excellence at York College

More Than Just Clothes?

• Basic etiquette must accompany appropriate attire. The two are intertwined and integrated when presenting a professional image of yourself [and your company].

• Non‐verbal clues: your handshake, your posture, eye contact, enthusiasm and confidence.

• Dressing for success is an essential part of your behavior and demeanor.

• George Washington’s Rules of Civility discuss forgotten ideals of how one should carry oneself; these are still very relevant today.

• Start dressing like the person you want to be and the success you desire will follow.



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Dressing for Success: Conclusion• The most basic trick to dressing for success is to

wear the attire for the job you wish to have. You must show that you are not just prepared for the promotion, but you know the dynamics of the title by dressing the part.

• Write down your goals and place it around your mirror. Make sure the mirror is a long mirror so you can see yourself from top to bottom. When you look at yourself, check whether you reflect what you want to be.

• Through what people see outside of you, they get a picture of inside of you; make sure you are showing your best reflection.

Contact Info:

Ashley Yawn, BS, CPC

[email protected]

Business Cards Available Upon Request



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Professionalism & Ethics - Complete · Integrity, Ethics and Professionalism •Ethical standards exist in every profession. Integrity is a key element of what every profession considers