Since 1928, the American Health Information Management Association (AHIMA) has been at the forefront in improving healthcare information management. Health Information Management (HIM) is the practice of the acquirement, storage, and protection of crucial information concerning patients’ health and other personal data. Widespread computerization has introduced Electronic Health Records (EHRs), which has continued to replace the traditional paper-based records.
How many times have your ICD-10 leadership team asked themselves the question, are we ready for the conversion? The clock is ticking and there’s very little time left for the healthcare organizations that are behind schedule. On October 1, 2015 the healthcare industry will begin to use, process, and exchange ICD-10. Providers and practices should be preparing themselves for the transition and approaching the implementation with confidence.
The healthcare industry generates a great amount of data every day, as a form of record keeping, patient care, compliance, and regulatory requirements. Just a decade ago, all this data was stored in the form of hard copy form, now it is rapidly transforming to digital data which is called EMR (Electronic Medical Record). The digitalization of the healthcare has not just reduced cost of care, but also improved quality of care due to the abundance data that organizations receive from the EMR to identify the flaws in their system.
One of the most popular health plans that people use is Medicare. One of the reasons why this is so is because it is public and goes towards making health coverage more possible. One payment plan states that people pay $104.90 monthly, with a $147 dollar deductible. Another payment plan under Medicare states that one has to pay $407 dollars monthly at the most. ("Medicare", 2015). The third payment plan varies and is dependent on the plan that they are using. Because the medical industry works to become more and more accurate in all medical terms, it is necessary for patients being just as accurate when applying (2015). This way, clients will get just the health plan they need.
The Joint Commission’s tracer methodology is used to ensure compliance standards are met, as well as to “trace” and document the level of care provided to patients in order to make improvements to the facility’s health care delivery system. Patients requiring services that utilize the entire continuum of care spectrum are selected in an effort to gather sufficient information needed to identify areas with potential risks and safety concerns. As the patients’ course of care progresses across the system, Joint Commission surveyors evaluate each department 's policy and procedure on data management, infection control and medication management process.
As a former student in M201/M202, I have to admit that I was a bit intimidated at the size of the ICD-10 CM/PCS coding books. However, as we began learning about the guidelines and rules to coding it all started to come together. Last year’s transition to ICD-10 for the United States, had required changes for all health care systems. With that being said, coders were now required to code more detailed information which makes it available for more frequent errors. Therefore, in this discussion I will explain two examples of minor errors that I had trouble with in M201/M202.
Padarthy proposes facilities analyze their current diagnostic and procedural codes to assess whether their current codes accurately represent services provided. In addition, he asks facilities to determine “if an opportunity to leverage ICD-10” exists, and if so, what is needed; updated eligibility requirements, increased medical necessity
Overall, incomplete documentation and delinquent medical records cause inaccurate reimbursement and results in inaccurate gross revenue to the hospital. It can have a negative impact on the hospital budgeting and financial planning process for the hospital. It is for this purpose that every healthcare institution should be purposeful on reviewing the accuracy and completeness in clinical documentation, no matter the cost. Even though, for most physicians, most of their time is focused on the actual care of the patient and there is little to no time to devote to extensive documentation, it is imperative to understand patient care includes both the one-to-one attention and the documentation of said treatment.
HCPCS Level II codes commonly are referred to as national codes or by the acronym HCPCS, which stands for the Healthcare Common Procedure Coding System. HCPCS codes are used for billing Medicare and Medicaid patients and have been adopted by some third-party payers. These codes, updated and published annually by the Centers for Medicare and Medicaid Services (CMS), are intended to supplement the CPT coding system by including codes for nonphysician services, administration of injectable drugs, durable medical equipment (DME), and office supplies.
A career in medical billing is a growing field that allows you to work within the healthcare industry. While you're not dealing directly with patients, you're providing a valuable skill that is the foundation of a great healthcare system. A medical billing specialist has a unique role in the world of healthcare that isn't diminished by being behind the scenes compared to the role of a doctor or nurse.
Since the addition of Crossing the Quality Chasm six aims of quality patient care was created by the Institute of Medicine (IOM), there has been a significant change in the effectiveness and condition of patient care. Before this report came out in 2001, health care providers did not realize that they were not providing proper care to patients in addition to disorganization and complexity of standards of care. The IOM was able to determine that, “failure of system processes, poor communication, and unhealthy work environments contribute to medical errors, ineffective delivery of care, and stress among health professionals” (Winterbottom 2012). It is essential for patients to feel
There are many different aspects of Advance Practice Nursing (APN) make that make the nursing profession unique and valuable. The competencies that comprise each advanced practice nursing discipline are vital in creating a solid foundation for clinical nursing. They prepare you to conquer challenges in the clinical setting and cultivate innovation to establish processes for clinical practice.