Health Information Management

Topic: Reduce delinquent records by determining the average and median time frame for receiving reports

HIM-HIPAA Insider, July 2, 2007

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Processing reports in a timely manner is compromised when an organization lacks a commitment to issue test results within a stated time frame, or when an organization has decentralized testing spread over many campuses or satellite locations. Assess the median and average time it takes to receive all reports for the same patient.

To calculate the median, take a sample of accounts (e.g., the first five and last five of each day for one week). Capture the number of days (in consecutive order) that it takes to receive all the materials for each account. Calculate half of the sample size and select that number in the array. This is the median.

For example, in a sample size of 20 encounters, line up each encounter in consecutive order according to the number of days for all information. Calculate half the sample size (10) and then select that number in the array. Look for the 10th encounter and scan across to the number of days for all information. You'll see that during the 10th encounter, it took three days for all of the information. Therefore, the median is three.

However, calculating the average requires a different method. For example, in a sample size of 20 different encounters, the average number of days to receive all documentation is the sum of all days divided by 20. Therefore, the average would be 80 divided by 20, which equals four days.

Using this example, the director passes the accounts to coding at day four to reduce rehandling of the account. However, four days may not be acceptable to the organization's discharge-not-final-billed goal. When this is the case, share the sampling exercise and agreed-upon actions during the next revenue-cycle team meeting. The coding process is easier for those coders who have access to physicians' orders via online diagnostic tests. Getting the record as promptly as possible after the service is the bottom line, and this must be HIM's first priority.

Editor's note: This article was adapted from HCPro's book More With Less, Second Edition, by Rose T. Dunn, RHIA, MBA, CPA, FACHE, FHFMA. For more information, click here.

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