Query Escalation Process

cbarnescbarnes
in CDI Talk Archive
Hello All- Could anyone share what their hospital is doing to promote their query escalation process ? We are trying to figure out what would work best for us and would appreciate all the advice we can get.

Thanks in advance,

Charlene Barnes, RN, CCDS

Comments

  • kshumpertkshumpert
    edited May 2016
    Hi Charlene,
    I have 7 days after discharge to get all queries answered. If the queries are not answered at that time, it is escalated to our CMO who then sends a letter to the physician. If the query is not completed within 7 days of the letter, the physician is suspended. I had 4 outstanding queries this week to clarify. It works!


  • cbarnescbarnes
    edited May 2016
    Thanks so much for the information on how your hospital handles their query escalation process. I haven’t heard from anyone else and would like to have more input. Is anyone else out there, willing to share ? Thanks Charlene

  • lindenbm@bellsouth.netlindenbm@bellsouth.net
    edited May 2016
    Our CMO will call the physicians who have outstanding queries. Sometimes that is all it takes but not always.
    I really like the idea of sending a letter to the physicians and the suspension process. The person who entered that response, do you have a standard letter that you would be willing to share?

    Thank you,
    Mary Lindenboom
    Clinical Documentation Manager
    Flagler Hospital
    Saint Augustine, FL
    904-819-4254
    Mary.lindenboom@Flaglerhospital.org

  • fishdl@shands.ufl.edufishdl@shands.ufl.edu
    edited May 2016
    When a query is created, we send a courtesy email to the physician letting him/her know there is a new Coding Query in their In-Basket. If it hasn’t been answered in three days, we send another email to the physician and copy his/her Chair. If it still hasn’t been answered in three additional days, we send another email, and copy both the Department Chair and our CMO. At that point, our CMO sends a quick / brief email stating, “Please do today”, and that usually takes care of it. We have never had a physician suspended for not answering a query.
    Thanks,
    Donna
    Donna Fisher, CCS, CCDS
    CDI Coordinator
    UFHealth Shands Hospital
    Ph: 352.265.0680 ext 48769
    fishdl@shands.ufl.edu
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  • lindenbm@bellsouth.netlindenbm@bellsouth.net
    Does anyone have sample letter sent by the physician advisor to noncompliant physicians?

    Thank you,
    Mary
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