At HCPro's Accreditation Specialist Boot Camp, we continue to receive questions about standing orders, protocols, and verbal/telephone orders. With spring on its way by the time this article is published, I thought a fresh look at these topics would be in order (no pun intended). Let's try to dispel the myths and go straight to what the regulations say and what is best practice to meet them.
Historically, the healthcare revenue cycle has been dominated by fee-for-service (FFS) payment arrangements that reimburse providers for the volume of care they provide. These reimbursement models have always been tempered by medical necessity determinations to ensure that the care delivered to patients is in fact medically necessary. Over the past several decades, healthcare costs have been rising precipitously. In response, new payment models have been developed to curb that trend and to deliver more cost-effective care with higher quality and better outcomes.
Organizations often struggle to finalize charts after discharge so they can be coded in a timely manner, but this process can be completed efficiently with direction from HIM professionals and coordination between departments.
HIM professionals are at the center of a shift from a paper-based to an electronic healthcare environment. As healthcare organizations work toward Meaningful Use attestation, there are standards that can help HIM professionals ensure that their electronic records are interoperable.
Many hospitals and health systems include computer-assisted coding (CAC) systems as a strategic tool in their plan for ICD-10. CAC software is considered an antidote to the significant decrease in coder productivity anticipated with ICD-10.
