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TOPIC: Learn the secrets to a lower delinquency rate

HIM Connection, September 16, 2003

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TOPIC: How low can you go?

Learn the secrets to a lower delinquency rate

What's your medical record delinquency rate? Hovering around 20%? Teetering toward 30%? Few hospitals can rival the rate at Harrison Memorial Hospital in Bremerton, WA, where Kelley L. Meeusen, RHIT, compliance coordinator and privacy officer, can boast a high of 3.28% and a low of 0.99%. And that's for a facility with 342 physicians on staff, 15,000 inpatient discharges, 45,000-50,000 outpatient discharges, and an estimated 60,000-70,000 emergency department visits a year.

We set out to learn Meeusen's secrets and discovered the success depends on "good old-fashioned methods of communication and consistency," he says. Meeusen suggests the following approaches:

* Include everything you analyze in your delinquency rate. By factoring emergency room (ER) visits and outpatient discharges into the figure, the total number of records is larger, which helps to lower the percentage.

* Staff an enthusiastic, competent clerk in the record completion area. Harrison's record completion clerk offers physicians a personal touch which helps increase compliance. The hospital has a 20-day delinquency cycle, so at the 10-day and 20-day marks, the clerk sends out a letter and personally calls each physician with incomplete records. If a record isn't complete within the 20-day time frame, that physician cannot admit any new patients until it's done. Harrison hasn't suspended a doctor in two years.

* Apply your policy consistently. Harrison's procedure has been consistently applied and enforced, Meeusen says. "Our doctors know exactly what to expect. We've never had a delinquency rate over 5%," he said.

* Inspire the physicians. Meeusen finds that physicians are much more likely to work toward compliance when rules and regulations are explained in terms of improving the continuum of care. "They really hate seeing issues as just another regulation," he says. "If I start talking about compliance, I meet a brick wall."

* No competition. Many facilities just won't be able to emulate Harrison Memorial on the last factor that Meeusen thinks helps keep the delinquency rate down-Harrison is the only hospital in a county with 30,000 residents.

This week's HIM Connection was adapted from an excerpt of the new edition of our best-selling book, "Mastering Records Completion 2" Go to HCMarketplace for more information or to order. Check out the Editor's Choice section below for a kit for training coders on the 2004 ICD-9-CM codes.

Sincerely,

Kate Alvarez
Editorial Assistant
kalvarez@hcpro.com

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