RE: cdi_talk digest: October 10, 2011
We recently had a change in the Medical Staff Rules and Regs that allows all RQs to be made a deficiency after 7 days and a suspension after 14. Our process is for coders to evaluate any concurrent query that remains unanswered against our criteria for RQ. If the concurrent query meets RQ criteria, we resubmit it as a RQ. CDS do all queries here for charts we reviewed, and the coders only do RQs for those a CDS never reviewed. If a RQ is required, we send it to the MD office via fax and then call to inform the office of time-sensitive fax coming through. At 7 days without response, we notify the VP/CMO and a deficiency is assigned by HI. The VP/CMO calls the MD and tells him about his deficiency and that he will be suspended at day 14 if no response. If suspended, he must appear before the credentials committee to explain himself to get his/her privileges back. We've never gotten to that level, but then it's only been two months since the change. We track responses by type and can track by query type if we like. We can also track by SOI/ROM and financial impact, which we are doing for administration. Hope that helps.