Are you in compliance with your offshore coding vendor? Please read my recently published article in HCPro's "HIM Briefings" (page 8) to better understand where your potential risks are and what you can do to address them.
On March 31, 2017, himagine will be presenting HIM Career Paths for 2017 and Beyond. HIM careers are expected to increase by 15% by 2024. Join us as we discuss AHIMA’s HIM Reimagined initiatives and introduce you to new and exciting career paths within HIM.
HIM departments across the country are continually challenged to retain their most highly skilled professionals. Quality coders are in high demand and HIM professionals are looking more and more to enhance their career opportunities. As a long time HIM department leader I have experienced first hand the difficulty of developing career paths for employees. The good news is that the HIM segment is poised for continued growth with job opportunities expected to grow by 15% by 2024. With a little planning and a commitment to your people you can make your facility a “destination” for HIM professionals.
Julia Hammerman, Director of Compliance and Education at St. Louis-based himagine solutions, and Terri Eichelmann, Director of Health Information Management at St. Louis-based BJC HealthCare, recently provided Becker's Hospital Review with tips for healthcare organizations and coders navigating the ICD-10 transition.
What if you could improve collaboration with physician stakeholders and concurrently bring your inpatient CDI program to the next level? This is possible through the development of an outpatient CDI program that incorporates the physician practice under its umbrella. Physicians are now looking for resources to assist in the implementation of MACRA and MIPS as well and to improve their HCC scores and receive appropriate reimbursement from risk based payers. Those consultations with your physicians related to chronic and secondary diagnoses treated in their professional practice could lead to increased specificity of ICD-10 coding for DRG accuracy and decreased denials in both the outpatient and inpatient setting.
In looking toward 2017, hospitals are beginning to seriously consider expanding their CDI program to the outpatient and professional fee world. The increase in patients covered under risk based payment is one reason. The increasing denials due to medical necessity are another. Managing reimbursement in the outpatient setting requires a closer look at the specificity of diagnosis documentation as well as a clear picture of the patient’s diagnostic process, the practitioner’s clinical judgement and the patient’s treatment during the encounter. Let’s look at an example:
Earlier this year, the Commission on Cancer released the 2016 Edition of the Cancer Program Standards: Ensuring Patient-Centered Care. This manual includes clarification and improved language to help further understand how the standards are intended and the criteria for compliance.
Topics: Cancer Registry
In 2015, himagine conducted its inaugural HIM Benchmark Survey in the midst of the preparation for ICD-10. At the time, approximately 56% of respondents reported that they planned to outsource at least a portion of their coding. In our 2016 survey, 63% of respondents indicated that they outsource, making it clear that most healthcare providers currently rely on some coding vendor resources and will likely continue to work with outsourced coders going forward.
In our soon to be released second annual HIM Benchmark Report, 70% of HIM leaders indicated they increased auditing efforts in 2016 and a whopping 96% projected to maintain or increase this level of auditing in 2017.
This week's post comes from National Compliance and Quality Audit Manager, Sharon Nichols, BSBEB, RHIT, CCS, CHTS-TR.