THIMA eNews - June 2010
President's Message
 Dear
Fellow THIMA Members:
As I sit down and write this article, it is truly a
bittersweet moment for me, as it will be one of my last acts as the president of
this amazing organization. It’s been an incredible year, especially as I
think back on all of the things we’ve accomplished together.
THIMA
put forth a successful resolution at AHIMA House of Delegate even while we were
assisting one of our state representatives in writing a bill and discussing the
new physician practice medical record copying fee bill during Hill Day in
Nashville. We also pulled together the “Connecting the Dots” HITECH
seminar, and that’s just naming a few of the group’s accomplishments.
When I first stepped into the role of President of THIMA, I was unaware of all
the work that was involved in the position, but without hesitation, I can say,
every bit of the exertion put forward was worth it. In each of my
“President Messages,” I consistently discuss the importance of volunteering, and
this message will not be different. But in this message, let me emphasis
one of the oft-ignored benefits of getting involved: the chance to get to
know and work with the other members of THIMA. The friendships I have
created throughout this year are priceless, and would not have been possible if
I had not entered this position. From across the state and across the
country, these are friends who have supported me through personal and
professional challenges. So, again, I encourage you to volunteer, starting
out on the local level and working your way to the state. The rewards may
not be financial, but the hidden jewels you discover are truly a treasure.
It has been my deep honor and privilege to serve as your president and now I am
proud to pass the gavel on to a wonderful person, Seth Johnson. So, I do
not say farewell, but simply…………….here is Seth!!!!!!!!!!!!!
Sincerely,
Elizabeth A Delahoussaye, RHIA
President-THIMA
Statutory Provision on 3-Day Payment Window
On June 25, 2010,
President Obama signed into law the “Preservation of Access to Care for Medicare
Beneficiaries and Pension Relief Act of 2010.” Among other provisions,
this law clarifies Medicare’s policy for payment of services provided in
hospital outpatient departments on either the day of or during the three days
prior to an inpatient admission (known as the 3-day payment window).
The new law clarifies Medicare’s policy to be consistent with how hospitals have
largely been billing the program as far back as 1991. Under this policy, a
hospital (or an entity wholly owned or operated by the hospital) includes, in
its charges for the inpatient hospital stay, charges for all diagnostic services
and non-diagnostic services “related” to the inpatient stay that are provided
during the 3 day payment window.
The new statute clarifies that
the term “other services related to the admission” includes “all services that
are not diagnostic services (other than ambulance and maintenance renal dialysis
services) for which payment may be made by” Medicare that are provided by a
hospital to a patient: (1) on the date of the patient’s inpatient admission, or
(2) during the 3 days (or in the case of a hospital that is not a subsection (d)
hospital, during the 1 day) immediately preceding the date of admission unless
“the hospital demonstrates (in a form and manner, and at a time, specified by
the Secretary) that such services are not related to such admission.” The
statute makes no changes to the billing of diagnostic services.
The
provision is effective for services furnished on or after June 25, 2010, the
date of enactment of the Preservation of Access to Care for Medicare
Beneficiaries and Pension Relief Act of 2010. The provision also prohibits
Medicare from reopening, adjusting or making payments when hospitals submit new
claims or adjustment claims for services that were provided prior to the date of
enactment in order to separately bill outpatient non-diagnostic services.
In the very near future, CMS expects to provide instructions to the hospital
community through its contractors advising them how to bill for related
therapeutic services provided during the 3- or 1-day payment window. Until
the instruction is issued, hospitals should include charges for all diagnostic
services and all non-diagnostic services that it believes meet the requirements
of this provision. If a hospital believes that a non-diagnostic service is
truly distinct from and unrelated to the inpatient stay, the hospital may
separately bill for the service provided that it has documentation to support
that the service is unrelated to the admission, consistent with the new
provision. Such separately billed service may be subject to subsequent
review.
Hospitals may continue to bill Medicare separately for
services provided prior to June 25, 2010 that are unrelated to an inpatient stay
provided that such a claim meets all applicable filing deadlines and the
hospital has supporting documentation that the service is truly unrelated to an
inpatient stay.
Source: CMS CMSProviderResource
Volunteer Spotlight - Alicia Blevins
Alicia Blevins, RHIA, CHP is
a Senior Practice Leader on the HCA Shared Services Division HIM Team. She
has been in this role since April of this year. The Senior Practice Leader
provides HIM operational subject-matter expertise for HIM operational projects
and initiatives; compliance risk assessments, investigations, and educational
programs. In her role at HCA, she was previously employed as an HIM
Project Coordinator with the Shared Services Group Project Services Team.
Prior to her roles at HCA, Ms. Blevins was employed at Erlanger Health System in
Chattanooga, TN. Ms. Blevins served in various roles during her tenure at
Erlanger. She was on the McKesson Horizon Patient Folder project
implementation team, and held the role of System Administrator
post-implementation. Ms. Blevins also held roles in Privacy, Release of
Information, and Record Completion.
Ms. Blevins is completing her
Masters Degree in Health Informatics and Information Management from the
University of Tennessee Health Science Center. She has a Baccalaureate
Degree in Health Information Management from the University of Tennessee Health
Science Center and a Bachelor of Science in Business Administration from the
University of Tennessee, Knoxville.
For THIMA, Ms. Blevins served as
President in 2007-2008. She has served on the Legislative Task Force, the
Recruitment Partners Task Force, and served as a local CSA President for the
Chattanooga Health Information Management Association. Ms. Blevins was a
past recipient of the THIMA Rising Star Award in 2002.
Ms. Blevins is
currently serving on AHIMA’s Nominating Committee. Other previous
volunteer activities with AHIMA include: Privacy and Security Council, Legal EHR
Workgroup, RHIA Test Construction Committee, and RHIA Job Analysis Task Group.
Social Media - Connecting You to THIMA
 By
now I am sure most of you are a part of or have heard of Facebook. Regardless of
whether or not you are a part of the Social Media band wagon, you are
undoubtedly impacted by some form of Social Media.
If you are not
convinced that this craze is here to stay, examine the research. A study
from Arbor Networks analyzed traffic from 110 of the world’s Internet Service
Providers and concluded that Facebook accounted for 0.5% of all internet traffic
in recent months. To put that into perspective, current estimates reflect that
Facebook’s traffic needs are now equivalent to more than 30,000 servers and are
growing. Even more impressive is that as of November 2009, Facebook reaches over
350 million users worldwide; that is huge marketing potential!
With the
surge of interest in Social Media, organizations are turning to Facebook and
LinkedIn for marketing and to communicate their message. Associations are using
these networks to connect to their members and to grow their membership. I am
proud to announce THIMA has entered the world of Social Media. We now have a
Facebook page and LinkedIn group and we invite you to join. These pages will be
used to communicate events, post news articles and pictures, and to foster
discussion. We encourage you to join us on Facebook and LinkedIn by accessing
the links directly to our pages. Simply click on the icons on
www.thima.org.
Seth Johnson, MBA, RHIA
EHR - Our Journey
Norton Community Hospital (NCH) is located in
Norton, Virginia, in the heart of Southwest Virginia and the Appalachian
Mountains. It is a not-for-profit, 129-bed, acute-care facility that has
been serving Southwest Virginia and Southeastern Kentucky since 1949.
NCH is the largest healthcare facility in the coalfield region and was the first
AOA (American Osteopathic Association) accredited teaching facility in the state
of Virginia, hosting residents in Internal Medicine. NCH is part of
the Mountain States Health Alliance healthcare system, located in Johnson City
Tennessee.
Prior to the EHR implementation, NCH utilized a hybrid record
platform. Outpatient labs and radiology reports were housed in the
Information System database and all other records were paper based.
Beginning April 1, 2010 the electronic health record system was implemented.
The EHR system allows for scanning of paper records post discharge.
Interfaces between EHR and other systems were built which ensures many reports
cold feed directly into EHR. Thanks to this technology, the entire patient
medical record is housed together and can be accessed post discharge. Once
analysis is complete, any deficiencies can be assigned to the physician and they
can immediately complete them on-line with the click of a button.
Deficiency and delinquency rates have already started showing a negative trend.
Two years of careful planning and preparation were needed for this transition.
The following is a synopsis of steps taken during this period:
-
Reports were run from the current information system showing all duplicate
medical record numbers. These duplicate numbers were then investigated
and merged. Once the duplicates were decreased significantly, a merge
of encounters into the Enterprise Access Directory (EAD) with MSHA took
place. The Admissions department was then trained to access EAD and
assign a Corporate ID number. The corporate ID number is a unique
number that identifies the patient at the corporate level, with the patient
having a unique medical record number at the hospital level.
-
Any system that generated a report that made up part of the permanent record
was reviewed to see whether an interface to EHR could be implemented.
Interfaces decrease errors, is more efficient, decreases need for scanning
post discharge, and provides faster accessibility to patient reports needed
by caregivers. The following documents currently interface with our
EHR system: lab reports, radiology reports, pathology reports,
transcribed reports, and nurses notes.
- Previously, patient
labels did not have the encounter number barcode. The new EHR system
requires that we scan at the encounter number level. Department
leaders were asked for feedback and they agreed that using the encounter
number barcode could be implemented without any negative outcome to their
systems. The label company assisted with making this change.
-
Training was very involved and necessary for successful implementation.
Since the EHR system was already in place at our sister hospitals, I had the
opportunity to train at other facilities in the areas of Prep/Scan/Verify,
Quality Assurance, Physician Completion and Analysis. Approximately 2
months prior to our go-live, I began training my staff. The staff was
educated on the 24 hour turnaround requirements of discharged charts being
in EHR, and productivity and quality standards.
-
Approximately 2 weeks prior to our go-live, the Medical Staff and Residents
were trained to review, edit, and complete deficiencies in their records in
EHR.
EHR has streamlined the care of our patients by giving
caregivers faster access, physicians can securely access their patients’ records
in the hospital and remotely, release of information is more efficient, which
all contribute to improved patient care. As governmental regulations
increase to ensure adoption of electronic health records, NCH how has greater
compliance with these mandates. Implementing EHR at NCH is already proving
to be a great asset as we move towards the future.
Melissa Johnson, RHIT
Director of HIM, Norton Community Hospital
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Upcoming Events
Save the Date!2011 THIMA Annual
Meeting March 14-16, 2011 Murfreesboro, TN
Available Jobs
To learn more, visit the THIMA Job BoardHIM Regulatory
Consulting Product AnalystHCA Coding Compliance Audit
Opportunity CHAN Healthcare Auditors
Senior Product Analyst, CORE Measure HCA, Hospital
Corporation of America MSHA Coding ManagerMountain States
Health Alliance
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