Physician buy-in-maybe another angle?
For the physicians, RACs seem to be an urban myth...they keep hearing about them but nothing happens, it is like the boy that cried wolf. So, this is not so effective when trying to get them on board.
ICD-10...they are struggling with electronic health records and see documentation as just another thing the hospital wants from them and that medicare has designed to keep them frustrated.
So...I have reasoned that they may become more interested if it affects them directly. Certainly, they also need more specificity for the office-for the insurance carriers etc. -no?
My new angle is to see if I can get an appointment with the office billing/coding manager and see if we can partner together for the accurate medical record.
To help make sure the physician level of billing is equivalent in terms of severity of illness/medical necessity to the hospital note.
And use the terminology that both the insurance carriers and medicare want.
I know there are a lot of differences with CPT codes vs inpatient coding ex/ I've been told they cannot do "rule out" in the outpatient setting but can on the inpatient side.
Can any of you give me some more ideas to present to the office billing/coding person? (I know nothing of outpatient coding)
My thought was.. if the doctor sees that their office biller/coder and the CDI are on the same team-we are after all partners with the physician for the best patient care-then the doctor will be more willing to interact with the CDI.
Thoughts?
Tips?
Ideas?
Thanks!
Charrington Morell, RN, CCDS
ICD-10...they are struggling with electronic health records and see documentation as just another thing the hospital wants from them and that medicare has designed to keep them frustrated.
So...I have reasoned that they may become more interested if it affects them directly. Certainly, they also need more specificity for the office-for the insurance carriers etc. -no?
My new angle is to see if I can get an appointment with the office billing/coding manager and see if we can partner together for the accurate medical record.
To help make sure the physician level of billing is equivalent in terms of severity of illness/medical necessity to the hospital note.
And use the terminology that both the insurance carriers and medicare want.
I know there are a lot of differences with CPT codes vs inpatient coding ex/ I've been told they cannot do "rule out" in the outpatient setting but can on the inpatient side.
Can any of you give me some more ideas to present to the office billing/coding person? (I know nothing of outpatient coding)
My thought was.. if the doctor sees that their office biller/coder and the CDI are on the same team-we are after all partners with the physician for the best patient care-then the doctor will be more willing to interact with the CDI.
Thoughts?
Tips?
Ideas?
Thanks!
Charrington Morell, RN, CCDS
Comments
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Focus on the E&M (evaluation and management) coding. Your outpt biller
will know about this. For most MD's this hits the pocket. There are
multiple references online and at ACDIS to reference.
Thank You,
Susan Tiffany RN, CCDS
Supervisor Clinical Documentation Program
Guthrie Healthcare System
phone: 570-882-6094, pager #465
fax: 570-882-6768
email: tiffany_susan@guthrie.org
"Twenty years from now you will be more disappointed by the things you
didn't do than by the ones you did do. So throw off the bowlines. Sail
away from safe harbor.Catch the trade winds in your sails. Explore. Dream.
Discover." Mark Twain
For example, I think Humana wants the physicians to document the type of CHF...that was the kind of information I am hoping to find in the outpatient environment so I can show the physician how they need it for their billing/insurance, impressing that it is NOT just for the hospital.
Does anyone know of specific examples of things like that?