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Medical Records Briefing

Issue 12, December 21, 2002 - VIEW THE FULL ISSUE

• Files and floods: NY hospitalfinds storage solution in the nick of time

  Too many charts and not enough space for them was causing a problem for the State University of New...

• Most HIM directors keep their department secure

  Survey shows access, monitoring, training under controlEditor’s note: Figures represent the...

• Picture a clear policy on photos and medical records

  The specific answers to the questions about who is responsible for photographs-whether they are...

• Watch high-risk areaswhen auditing E/M services

  Many coding experts have called for scrapping E/M codes altogether—but for now the codes...

Issue 11, November 21, 2002 - VIEW THE FULL ISSUE

• 2003 Work Plan

  The 2003 Work Plan, released by the Office of Inspector General (OIG) on October 2, includes many...

• HIM fills in missing link in trauma registry

  When Cook County Hospital (CCH) in Chicago started collecting more than 110 variables...

• Make your documentation spicy, not vanilla

  By Robert S. Gold, MD, Healthcare Management Advisors, Inc.One roadblock in the designation...

• Mayo Clinic tests speech recognition and decides to wait

  Pilot finds current technology doesn’t save much timeBecause of the...

• What’s in a name?

  Directors battle confusion to update department titlesHealth Information Management, Patient...

Issue 10, October 21, 2002 - VIEW THE FULL ISSUE

• Clearing up the confusion about ongoing record review

  Clearing up the confusion about ongoing record review

• JCAHO's shift toward systems improvement increases HIM role

  JCAHO’s shift toward systems improvement increases HIM role

• Realizing the impossible dream: NH hospital has no delinquent records

  In the July issue of MRB, we told you about Bremerton, WA-based Harrison Memorial Hospital's...

• Stringent policies for assigning attending physicians

Issue 9, September 21, 2002 - VIEW THE FULL ISSUE

• Coding benchmarking 101: Check the accuracy of your data and decide how youR

  Editor’s note: This article is the second in a two-part series on benchmarking. Last month...

• Data integrity position devoted to reducing duplicates

  Duplicate medical record numbers and incorrect patient information can complicate...

• Physician scribes: Improve documentation and patient care

  With the ever-increasing focus on good documentation for compliance and reimbursement efforts...

• Survey shows few changes in how hospitals handle transcription

  Experts say no end to shortage in sightEditor’s note: Figures represent the responses...

Issue 8, August 21, 2002 - VIEW THE FULL ISSUE

• Benchmarking 101: Consider levels, code sets, and documentation

  Part one of a two-part seriesComparing your coding data with other facilities’ is...

• CMS announces 146 new ICD-9-CM codes for 2003

  More specific codes require more detailed documentationSettings other than acute care are...

• Surprise! Handling a random unannounced survey

  In February, just a week before a mock survey she already had planned with her insurance company...

• Tackle JCAHO’s toughest IM challenges

  JCAHO’s information management (IM) standards continue to be among the organization’s...

Issue 7, July 21, 2002 - VIEW THE FULL ISSUE

• A new resource for ongoing record review

  Is ongoing record review (ORR) taking up too much of your time and causing you stress and worry...

• How low can you go?

  WA hospital’s delinquency rate couldn’t be much better; HIM compliance coordinator...

• Protect your facility by scrutinizing the release of patients' medical information

  When it comes to protecting your patients’ medical information the burden is on you and the...

• Questions to ask before developing a remote work program

  “It’s no secret that there’s a shortage of qualified coders and...

Issue 6, June 21, 2002 - VIEW THE FULL ISSUE

• Hospitals could be missing out by not staying on top of chargemasters

  Editor’s note: The following is based on 204 responses to a survey sent to subscribers of...

• Managing medical records in a toxic cloud

  ND hospital treats more than 1,100 patients after local chemical spillWhen a Canadian Pacific Rail...

• Privacy officials can share tasks, delegate responsibility

  Many facilities have yet to appoint a privacy officer, speaker Jill Callahan-Dennis, JD, RHIA...

• Tracking productivity ups transcription efficiency

  Finding a standard is step one toward incentive pay program, increased job satisfactionDaniel...

• Using auditing and monitoring to track problems

  Both monitoring and auditing assess the effectiveness of operations and controls, but you...

Issue 5, May 21, 2002 - VIEW THE FULL ISSUE

• Changing documentation after the fact equals fraud

  Altering patient status to get paid is wrongWhen a denied claim comes back, it’s tempting...

• HIM has customers, too

  Survey other departments for ways to improveJust because no one in the HIM department is...

• Proposed privacy changes affect consent and marketing

  The proposed changes to the HIPAA privacy rule announced March 21 by the Department of Health and...

• Survey shows HIM directors in expanded roles

  In this second of a two-part series, we’ll discuss how regional and hospital size...

Issue 4, April 21, 2002 - VIEW THE FULL ISSUE

• Hospital cancels scheduled surgery when doctors delay dictation

  Hospital cancels scheduled surgery when doctors delay dictation

• Maine hospital opts for compromise on abbreviations

  Consolidating, cross-referencing policies makes them easier to useIncreased medication...

• Survey shows HIM professionals’ salaries, responsibilities on the rise

  Editor’s note: This article is the first in a two-part series. Figures rep-resent the...

• Universal chart order—not necessarily a universal solution

  Universal chart order can reduce assembly work for HIM clerks, make finding reports easy, and...

• Watch your back on informed consent

  Ensure that your facility maintains solid documentation practicesYour doctors are...

Issue 3, March 21, 2002 - VIEW THE FULL ISSUE

• Computer systems make ‘legal’ record tough to define

  It used to be simple and straightforward. When a patient requested a copy of his or her record...

• Department overwhelmed by phone calls uses faxes to reduce interruption

  While working as an interim director in a 290-bed hospital last year, Mary Mike Pavoni, MS, RHIA...

• IM.5 tells surveyors to pay close attention to legibility of orders

  Health system implements program to eliminate handwriting horrorsRevisions to the intent of JCAHO...

• Keep information flowing when disaster strikes at your facility

  Write, test, and revise recovery plansIt pays to think about the unthinkable—fires, floods...

• Survey shows most hospitals combine open and closed record review

  Editor’s note: Figures are based on the responses of 347 hospitals in these bed-size...

• This month’s idea: Combine release authorization form with discharge ins

  When doctors send their patients to the emergency room (ER), they often want to follow up to find...

Issue 2, February 21, 2002 - VIEW THE FULL ISSUE

• Dedicate one employee's time to daily MPI updates

  Dedicate one employee’s time to daily MPI updates

• Getting started on the HIPAA privacy official's to-do list

  Getting started on the HIPAA privacy official’s to-do list

• New rules on medical necessity should clear up some confusion

  New rules on medical necessity should clear up some confusion

• OIG says overpayments for preadmission services dropped

  OIG says overpayments for preadmission services dropped

• This month's idea: Pay your transcriptionists solely by production

  This month’s idea: Pay your transcriptionists solely by production

Issue 1, January 21, 2002 - VIEW THE FULL ISSUE

• HHS issues anthrax coding advice

  HHS issues anthrax coding advice

• Make sure you are meeting the billing criteria for outpatient observation serv

  493.21 - Chronic obstructive asthma with status asthmaticus 493.22 - Chronic obstructive asthma...

• MRB 2001 Index

  MRB 2001 Index

• Spell out your facility's rules on verbal orders and train staff

  Spell out your facility’s rules on verbal orders and train staff

• Follow these tips to avoid a troublesome standard

  Follow these tips to avoid a troublesome standard

• Texas hospital uses residents when short on coders

  Texas hospital uses residents when short on coders

• This month's idea: Make a contest out of filing your loose sheet backlog

  This month’s idea: Make a contest out of filing your loose sheet backlog