It's a prevailing trend?HIM directors and managers are overworked and underpaid. The results of MRB's 2015 HIM director and manager salary survey shows this trend remains firmly in place, although it does indicate these professionals' annual earnings have seen a slight uptick.
Throughout the years, this column has focused on the important role the electronic document management system (EDMS) plays as the official legal health record (LHR) within a healthcare organization, and especially as a critical workflow tool for the HIM department. I am always surprised to hear that there are still some facilities that haven't figured this out and purchased an EDMS.
Incentives posed by the Institute for Healthcare Improvement's Triple Aim Initiative and value-based purchasing emphasize treating the whole person to include preventive, medical, dental, postacute, community, mental health, and addiction services.
Last month, we laid the foundation to promote successful engagement of the coding and clinical documentation improvement teams in PSI 90 performance improvement efforts.
It's been two years since the American Health Information Management Association joined ACDIS to offer the industry physician query instructions in Guidelines for Achieving a Compliant Query Practice, published in February 2013.
As required by The Joint Commission, a board of directors should regularly assess its performance, appropriateness of board and committee processes and charter fulfillment, adequacy of meeting structures and goals, communication with management, and other governance structures and activities. Generally, boards and their committees complete this assessment through self-surveys, internal audits, or collection of results as performed by legal services. Assessment results can lead to changes in board processes, with the goal of adapting to changing risks and environmental requirements, and improvements in governance.
Conducting pre-billing audits can be challenging, but when done correctly, it can save organizations from spending time recoding and rebilling claims that payers deny. These audits can be conducted on the front end, in both inpatient and outpatient settings, once records have been coded.
Q: You are reviewing a computer-generated insurance claim before it is sent to the insurance carrier, and you happen to notice the patient's name on the claim?it's an old friend of yours. You quickly read the code for the diagnosis. Is this a breach of confidentiality?
Since the implementation of the Hospital Value-Based Purchasing (HVBP) Program in 2013, CMS has adjusted the MS-DRG payment for each traditional Medicare discharge. The type and amount of the adjustment, which could be a financial penalty and/or an incentive payment, is determined by the hospital's performance for defined quality measures, such as risk-adjusted mortality. Since that time, the number of pay for performance (P4P) programs and quality measures has expanded. By 2017, P4P payment adjustments will impact up to 6% of traditional Medicare revenue.
