consequences for non-responders

sbeattysbeatty
edited May 2016 in CDI Talk Archive
What do your respective organizations do when a physician fails to
answer queries or participate in your efforts despite repeated
intervention by the MD advisor? Is this part of credentialing, or on a
report card, or are there any consequences at all? Thanks.



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Sandy Beatty, RN, BSN, C-CDI

Clinical Documentation Specialist

Columbus Regional Hospital

Columbus, IN

(812) 376-5652

sbeatty@crh.org



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Comments

  • Unknown
    edited May 2016
    I have up to 48 hours post discharge to get my queries answered. If I cannot accomplish this, the coder evaluates and if the coder agrees with the query, she re-issues it and it comes up as a deficiency for that chart.
    For very reluctant physicians, the CFO takes over.

    Charlene


  • stacy.vaughnstacy.vaughn
    edited May 2016

    Our queries post discharge enter the deficiency process if the coder finds
    it is still unanswered. Then it will go to the regular chart completion
    standards would could ultimately lead to suspension.






  • dallend@einstein.edudallend@einstein.edu
    edited May 2016

    We just started fining our residents (they are responsible for responding to queries) if a query goes unanswered after discharge for 2 weeks.
    These would be queries with no response prior to discharge and our coder initiated post discharge queries.


  • Unknown
    edited May 2016
    What is the fine for the unanswered query?

    Charlene


  • dogdog
    Yikes, Deb, is that legal? I can only imagine how much your residents would appreciate the CDMP program after having money taken away.

    If a physician is particularly recalcitrant after I've hunted them down, faxed, paged, etc., then as a matter of practicality, I assume they are not going to give me the response I want. My boss wants accounts billed within four days of discharge, and will not hold a chart or rebill for a query that does not impact the DRG. In fact, she doesn't want me to pursue a severity query after the case is billed, because it would have to be rebilled with the new codes with no additional financial return.

    Renee

    Linda Renee Brown, RN, CCRN, CCDS
    Clinical Documentation Specialist
    Arizona Heart Hospital
  • dallend@einstein.edudallend@einstein.edu
    edited May 2016

    The fine is not a lot - it's like 10.00 a chart every so many days or so. They can get fined for other chart deficiencies also. It's part of their contract. If you add up all of the deficiencies some of them have - OP reports, discharge summaries that need to be dictated for example - it can add up.
    Actually our attendings can have privileges suspended if they don't complete their charts. They need to sign their attestations, sign the dictated op reports and dc summaries - they have so many days to complete their deficiencies also.
    We do hold bills for our post discharge queries - usually 2 wks. Some impact DRG but others are for severity. We will hold bills for skin ulcers, resp failure, pna clarification, DM clarification (our diabetic center runs reports for controlled and uncontrolled DM), CHF clarification, CKD 4 or 5 - things that are considered important from our managements perspective. We also hold charts for path report documentation.
    After 2 wks we reevaluate and make a decision re: drop or hold. We usually have the case resolved by then but every once in a while there is a problem.
    I started a new process about a week ago. We text page all of our chief resident, our firm chief residents and the residents responsible for the queries in one big page, we also email them as a group - the response was amazing. Nothing like peer pressure to get the job done. We enjoyed ourselves!!
    Debby



  • robert.hodges2robert.hodges2
    edited May 2016
    Right now I just track it. I may start reporting no responses one day
    but it will be up to the service chiefs to take any action.



    Robert



    Robert S. Hodges, BSN, MSN, RN

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC

    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov



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  • Unknown
    Except for the hospitalists, there are absolutely no consequences for non-responders at my facility. It is discouraging, to say the least.
  • cbarnescbarnes
    edited May 2016
    There's no consequences for our non-responders @ our hospital either. The attitude seems to be we're the ones @ fault if a doc won't respond. After 10 years it seems the higher-ups would take a more affirmative position especially in todays atmosphere.


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