AUDIO CONFERENCE ON CD OR AUDIO ON-DEMAND
Sponsored by the Association of Clinical Documentation Improvement Specialists
presented on November 6, 2008
Physician queries—the act of asking physicians to clarify documentation in the medical record in order to achieve a more accurate diagnosis for quality and reimbursement purposes—has been an ongoing compliance concern for hospitals. Specifically, clinical documentation improvement (CDI) specialists, or other professionals who perform queries, have to be able to recognize the information that should prompt a query, and then be able to ask the query in a non-leading manner. Asking leading queries only to improve reimbursement can be construed as fraud.
The American Health Information Management Association (AHIMA) revised its practice brief for physician queries and will publish it in the October 2008 Journal of AHIMA. During this informative 90-minute audio conference, our speakers walk you through the new guidelines and offer practical steps for implementation, as well as offer samples of compliant and non-compliant queries for a variety of common diagnoses.
You will be well prepared to implement new policies and processes to comply with the new guidelines, and know how to
- Construct a compliant physician query based on the new AHIMA guidelines
- “RAC proof” a physician query
- Differentiate between leading and non-leading queries
- Overcome physician push back/query resistance
- Implement a hospital-wide plan of action regarding queries
This is an intermediate-level audio conference. Purchasers should have a basic understanding of Medicare-severity DRGs and the inpatient prospective payment system, official ICD-9-CM coding and reporting guidelines, and AHIMA’s 2001 Practice Brief on Physician Query.
Take a look at the agenda:
- New AHIMA physician query practice brief
- Comparison of proposed and final brief
- Exploring the query process
- Pros/cons of existing query models
- Compliant query examples
- Pneumonia
- Congestive Heart Failure (CHF)
- Open-ended examples
- Leading/noncompliant examples
- Removing v. making the query form part of the record
- What the new AHIMA query brief means to your CDI program/compliance implications
- Determining your facility’s course of action
- Development of clinical indicators on which to base queries
- Common diagnoses and their clinical indicators, based on accepted medical literature
- Targeting queries using clinical indicators
- Developing a hospital-wide policy for clinical indicators
A question and answer session follows the presentation.
LEARNING OBJECTIVES
At the conclusion of this audio conference, you will be able to:
- State the components of the new AHIMA practice brief
- Explain the implication of the new brief and associated process changes
- Draft compliant queries using the AHIMA query brief as a basis
- Use clinical indicators to develop effective queries
MEET THE SPEAKERS
James S. Kennedy, MD, CCS, is a director in the FTI Healthcare group of FTI's Corporate Finance practice in Brentwood, TN. His expertise includes physician and hospital leadership, healthcare systems improvement, healthcare documentation and coding compliance, and government relations. He regularly educates physicians and hospital staffs on these topics, promotes physician data quality, the facilitation of outcomes measurement and physician re-credentialing, reductions in payment denials, and averting legal and compliance issues for healthcare entities.
Marion Kruse, MBA, RN, is a director in the FTI Healthcare group of FTI’s Corporate Finance practice in Atlanta. She is a recognized expert in Medicare regulations, provides education, project management and process improvement, and has implemented clinical documentation improvement programs for small and large hospital systems. She is an experienced bedside and recovery room nurse, utilization case manager, and has extensive knowledge of the severity-adjusted DRG system, medical records, coding, charge analysis, patient accounts, and billing compliance.
BONUS MATERIAL INCLUDED IN YOUR MATERIALS PACKET
In addition to the expertise and advice presented during this audio conference, you'll also receive a slide presentation of the program materials and copies of the following:
- Sample queries
- Synopsis of CDI-sensitive clinical indicators of common conditions
- Links to related articles
These materials are provided with PDF links.
CONTINUING EDUCATION CREDITS
This program has prior approval of the American Academy of Professional Coders for 1.5 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the Academy of the program, content or the program sponsor. Credits expire October 31, 2009.
WHO SHOULD LISTEN?
CDI specialists, HIM directors, coding managers, inpatient coders, compliance officers, compliance analysts, physicians, and physician champions.
AUDIO ON-DEMAND
In addition to the regular purchase options for HCPro audio conferences, we are pleased to offer another option, audio on-demand. Audio on-demand allows you to download the program and play it back at your convenience through your computer or MP3 player. Purchase a CD or audio on-demand of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.
Save money when you purchase multiple copies! Ask your customer service representative about money-saving
discounts and bulk orders. Call toll free 800-650-6787 or e-mail
customerservice@hcpro.com.
