Health Information Management

Perform regular query audits to ensure effectiveness

HIM-HIPAA Insider, March 3, 2009

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

Facilities should regularly perform query audits to ensure they are effective. To do so, monitor the query process by reviewing a representative sample of all queries performed and a sampling of a specific coder’s queries.

According to AHIMA, an effective program should audit the following:

  • Percentage of positive and negative query responses. A high percentage of negative responses may mean coders are querying unnecessarily, whereas a high percentage of positive responses may indicate physicians may need education to rectify a pattern of incomplete documentation.
  • Format of queries. Education for coding professionals may be necessary if trends showing inappropriate query formats are present.
  • Individual providers. This format of monitoring will indicate whether specific healthcare providers would benefit from additional documentation improvement education, resulting in a decreased number of queries for the provider.
  • High-risk diagnoses. Auditing problematic diagnoses may show whether additional education on specific diagnoses would be helpful.

Editor’s note: This tip was adapted from a white paper on physician queries that was published on HCPro’s Revenue Cycle Institute Web site. Download a free copy of this white paper by visiting the site.

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular