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.
Hardly a week goes by in the healthcare field without another announcement of a regulatory change, delay, or new initiative. Technology innovation seems to outpace our ability to absorb change or install the latest update on various systems and software applications.
Coding tells a patient's story, based on the narrative the physician provides in his or her documentation. Accurately painting a picture of the patient's severity of illness (SOI) and risk of mortality (ROM) is essential for good patient care, and it is becoming increasingly important for quality measures and payment.
