Answering Queries: What's your method?
We are trying to come up with a process to get our queries answered in a timely manner. Currently, we rely on the chance encounter with the physician we have queried and mostly on the "honor system" of their "good graces" (not a very reliable method 
)
Mostly it's a wish and a hope they will answer. Some do - most don't.
We are not currently presenting any query stats to any meetings or administration. They are not penalized or held accountable if they choose to ignore the queries.
Our Hospitalists are more cooperative, of course. We have them answer "negatively" on the query itself (our queries are not permanent) and "positively" within the chart. We let them know if they are slacking off.
What process(es) do you go about getting your queries answered?
Do you hunt physicians down in the hospital - how time-consuming is this? How much time does it take away from your productivity?
Do you email physicians to let them know there is a query to be answered? Call their offices or page them personally to let them know? Does your software or EHR tally it as a "delenquence" for them - or alert them in some way?
Is administration involved in the process? Do they "penalize" physicians if they do not answer queries? Are your query statistics presented at Medical Staff meetings?
What about Case Management or other departments? Do you rely on their assistance to get your queries answered?
Would greatly appreciate your vast wisdom, knowledge and experience regarding this subject!!!
Norma Brunson, RHIA, CCDS
)Mostly it's a wish and a hope they will answer. Some do - most don't.
We are not currently presenting any query stats to any meetings or administration. They are not penalized or held accountable if they choose to ignore the queries.
Our Hospitalists are more cooperative, of course. We have them answer "negatively" on the query itself (our queries are not permanent) and "positively" within the chart. We let them know if they are slacking off.
What process(es) do you go about getting your queries answered?
Do you hunt physicians down in the hospital - how time-consuming is this? How much time does it take away from your productivity?
Do you email physicians to let them know there is a query to be answered? Call their offices or page them personally to let them know? Does your software or EHR tally it as a "delenquence" for them - or alert them in some way?
Is administration involved in the process? Do they "penalize" physicians if they do not answer queries? Are your query statistics presented at Medical Staff meetings?
What about Case Management or other departments? Do you rely on their assistance to get your queries answered?
Would greatly appreciate your vast wisdom, knowledge and experience regarding this subject!!!
Norma Brunson, RHIA, CCDS
Comments
Dawn
We do have a pretty good response rate and with some new software we got last month will start reporting provider turnaround times.
Robert
Robert S. Hodges, BSN, MSN, RN, CCDS
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
"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens
At my facility queries:
- are a permanent part of the chart
- tracked daily by the CDS
- if not answered the CDS actively looks for the provider (copies of all queries are carried by the CDS in case of a 'chance' meeting)
- the CDS has 48 hrs post discharge to get a query answered
(it has been determined here that it is more efficient to hold the bill up for the CDS to get queries answered than to go through the coder process)
- if not answered within 48 hours, the coder takes over and the physician gets a 'deficiency' until completed
- on rare occasion the coding supervisor will allow another day
Probably 95% are answered in house by the physician or with CDS verbal encounters. Maybe another 3-4% answered within the 48 hour limit and the last 1-2% the coder takes over.
As far as productivity goes, an average of 15 reviews (new and re-reviews) make up a good day. Our HIM directors feeling is if the CDS is not getting their queries answered in a timely fashion the situation is no different than just letting the coder do it after discharge. Our focus is on if you place it get it answered so the coder has a completed chart at discharge.
I have seen the 'productivity' numbers of others posted on CDI talk in the past. I do not know what is expected of the CDS' who review 30-50 records each day. Is productivity (i.e. the number of records reviewed) the main focus or getting a lesser number of reviews and a complete record at discharge the goal?
Charlene
Other than the query placed via EPIC In-basket (as well as still placed in the paper chart -- though that is more to ensure our worksheets and queries are scanned and saved as business documents not part of the legal medical record -- the docs are not into the paper chart with any sort of frequency anymore with all electronic physician and clinical documentation) we look to catch the docs on the floor & page them. Separate email is not terribly effective for us.
We also have a physician advisor (with limited hours) who occasionally will be able to directly contact (page/phone) though the focus is on the KEY post discharge queries (that really need to be answered to adequately and correctly code the chart).
Don
If there is a major issue we notify any or all of the above - our answer rate is 100%. If there is a concurrent query that is unanswered they have to answer it post discharge.