Weekly Goals

I've had a super busy past two weeks with training for our EHR and I'm hoping to fall into some sort of regular routine now. Let's see how I did on my last set of goals.

• Create Roles and Authority for HCS.
• Create new logins and profiles for the training sessions this week. 
• Schedule all 6 training sessions for the next 2 weeks for HCS. 
• Continue to work on the IDT Care Plan form. I actually decided to delegate this project to someone else.
• Get the DNFB down to 2 days.
• Finish decorating the HIM department pumpkin for the hospital contest. Our pumpkin was awesome but another department won.
• Put in a bulk order for binders for the user guides for HCS. 
• Print all of the user guides needed for the training sessions. Remember to include log in instructions.
• Request lunch for next Thursday's training for the chief officers of the hospital.
• Follow up with the head biller for the contract and fee schedule project.
• Run the monthly reports on Thursday for stats.
• Create the recommended suspension list for delinquent physicians.

I kicked butt last week. Now, on to this weeks goals...

• Complete HIPAA policy for electronic communications. 
• Begin framework for overhauling our UR committee and procedure/plan.
• Complete conversion master list for our MPI. 
• Pull chart for this week's UR meeting.

What are your goals for the week?

 

What I've Been Up To??

This is my calender for this week and I'm so mentally tired. What was your week like?

Getting My Head Above Water

When I took my current position it had been vacant for six months due to the previous director retiring and I knew that I had a backlog of work on day one. Within a month the HIM clerk of my department decided to tenure her resignation to move back to south Texas and I was lost because I truly didn't have my bearings at that time.

I hire a new clerk that I'm not able to properly train and orientate to my department because we are both new here and have clue what's going on and what the problem areas are...clearly I'm worried now. Fast forward 10 months and my clerk has to be laid off due to cut backs at the hospital and I'm left alone in a two person department to do EVERYTHING myself.

I'm not painting a pretty picture because it wasn't a pretty picture. There were stacks of non-assembled and non-analyzed charts, backlogged delinquent charts because I didn't have time to chase doctors and I'm losing my mind. Oh, did I mention that we also entered our Joint Commission window for survey? Yep and I as I entered the hospital each day, I prayed to the hospital gods for JC not to show up....

 

Weekly Goals

Let's recap last weeks goals:

• Contact APS regarding census information for outpatient services to relay ADT information to the transcription company.
• Meeting minutes for the EHR implementation project.
• Follow up on EHR projects that are due this Friday.
• In-service the unit secretaries on the new logins for the transcription company.
• Begin audits on the outpatient Time Out forms. (4 month project)
• Complete design on new Interdisciplinary Team Conference/Care Plan forms. A work in progress
• Make sure new employee is listed in ADP and complete time for last week. 
• Get the DNFB down to 2 days.I got it down to 3 days.

Okay, I did pretty good last week but this week is going to be a crazy one. Let's go:

• Create Roles and Authority for HCS.
• Create new logins and profiles for the training sessions this week. 
• Schedule all 6 training sessions for the next 2 weeks for HCS. 
• Continue to work on the IDT Care Plan form.
• Get the DNFB down to 2 days.
• Finish decorating the HIM department pumpkin for the hospital contest.
• Put in a bulk order for binders for the user guides for HCS. 
• Print all of the user guides needed for the training sessions. Remember to include log in instructions.
• Request lunch for next Thursday's training for the chief officers of the hospital.
• Follow up with the head biller for the contract and fee schedule project.
• Run the monthly reports on Thursday for stats.
• Create the recommended suspension list for delinquent physicians.

That's all I can think of right now but it's already a pretty big list. What do you guys have planned for the week? If you're in school what are you studying? Have a great week!

 

Weekly Goals

On my personal blog I do weekly post regarding my goals and I think I'm going to practice that on this blog.

• Contact APS regarding census information for outpatient services to relay ADT information to the transcription company.
• Meeting minutes for the EHR implementation project.
• Follow up on EHR projects that are due this Friday.
• In-service the unit secretaries on the new logins for the transcription company.
• Begin audits on the outpatient Time Out forms. (4 month project)
• Complete design on new Interdisciplinary Team Conference/Care Plan forms.
• Make sure new employee is listed in ADP and complete time for last week. 
• Get the DNFB down to 2 days.

What's your goals for the week?

I've Been Busy!

We are currently having our survey so I'll be back next week!

The Coder

Position Title: Coder
Immediate Supervisor: Director of HIM, Manager of Clinical Data, or Coding Supervisor
General Purpose: to apply the appropriate diagnostic and procedural codes to individual patient health information for data retrieval and analysis and claims processing.

Responsibilities: 

• Abstracts pertinent information from patient records. Assigns ICD-9-CM or HCPCS codes, creating APC or DRG group assignments.
• Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. 
• Keeps abreast of coding guidelines and reimbursement reporting requirements. Brings identified concerns to supervisor or department manager for resolution.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines.

Qualifications: 

• Minimum of successful completion of a coding certificate program in a program with AHIMA approval status. Certification as RHIA, RHIT, CCS, CCS-P, CPC or CPC-H preferred.
• Coding certification from AHIMA preferred. 
• Work experience as a coder or strong training background in coding and reimbursement preferred. 

I always encourage anyone that's an RHIA or RHIT to work as a coder for a few years because it gives you options as a fall back career. Plus you can make some pretty decent money as a part-time or PRN coder.

My HIM Life Right Now!

Work is getting so busy!

We are in full swing for our EHR conversion and are working on the financial portion of the implementation. I've dealt with some many master list that my eyes are crossed. But, I'm so excited to be able to gain this sort of experience as the project manager.

My role at work is expanding so fast that if I think about it too much I might panic. I've added two FTEs and 1 PTE and I've taken on the role of CDI and ICD10 documentation educator for the physicians at my hospital. We've added 3 outpatient clinics and 2 ASC and it's forced me to learn about the outpatient quickly and that's overwhelming.

These changes have forced me to become more aggressive at work but it's yielding great results that have made my chief officers very happy and is adding dollars to our bottom line, that will always put you in the good graces of the chief officers.

It's so nice to work somewhere that appreciates my body of knowledge and skills. That's not something you run across everyday so when you do, enjoy it and be thankful.

What's going on in you HIM life?

Answers Monday

Anonymous submitted this question via comment:

My question is, "If you have Bachelor's degree in Computer Information Systems" could you still be considered qualified to get on in the HIM department of hospital. I am currently taking a Health Information Management career training course from Penn Foster and I was wondering if I would have the credentials to even get hired for these types of positions?

Thank you for your question. Now, CIS people have a huge advantage in the HIM field due to the fact that EHRs are becoming standard in so many facilities. I work in a LTACH and we are in the middle of implementing a full EHR and it enloves so much IT/IS work that someone with that type of experience is greatly desirable.

If I had that type of background the first places I would entertain for possible employment would be the EHR software providers. There's always a need for development and conversion project implementers.  Some of the few companies I'm familiar with are EPIC, Allscripts, HCS Interactant, Softmed, Healthland, and Horizon Patient Folder.

Please read this article to find out opportunities for education/certification options.

I hope that helps!

Hey Everyone!

Source

On Monday, May 13th, with an Answers post!

I Shall Return...

I shall return the first full week in April! I've had a few life changing events and need some time to adjust to my new life and I appreciate everyone's questions and visiting the blog!

Is Coding For Me?

I usually advise so to be graduate to become a coder at some point in their career, get good at it and keep their skills fresh. Why you ask? Because you can always make extra money as a PRN coder.

Coding isn't for everyone. Personally, I don't enjoy sitting in a cubicle reading charts all day and coding. I don't enjoy generating queries or hunting for operative reports and anesthesia times. Yet, I do enjoy having the skill and being able to profit from it. Hospitals are always looking for coder and agencies such as Maxim Healthcare and On Assignment are always looking for coding talent that can be used in several different capacities.

Travel coding is a big thing and could be great if you're single and not tied down to anything. Agency contracts can be short and long term and might suit the personality of different people. Some people like the freedom of being contract coders and almost all enjoy the pay.

I've been a coder in the past but it's the main job function that I have now. Yet, I do PRN work for one of my former full-time employers and I make a really decent supplemental income from few hours of work. So, even though it may not be your thing, getting some coding experience might financial benefit you in the future.

Answers Monday!

From Tiffany M:

I was wondering that as well. Julie.. I am finishing up my degree in Health Information Technology at Devry University which is CAHIIM approved and will be doing my last class which is my internship this May. Also Devry is trying to secure me to do my internship at a hospital nearby me and I will be taking a RHIT prep course with Devry and if I pass the prep course they will pay for me to take my RHIT certification test. I have a year experience of working in a hospital as a Unit Secretary and I am currently working at a medical malpractice insurance company. I want to be a hospital coder. Graduation for me is so close should I try to obtain any position in the hospital now to hopefully move to the coding department atter graduating or just wait until I do my internship this May and hope to secure a position?? Thanks and I love your blog and videos .

I forgot to also add I am planning on taking my RHIT exam this July. I want to take it as early after graduation as possible so the information is fresh on my mind. 

Answers Monday!

From Ummi:

I was thinking also for the people who are not able to find anyone to hire them without experience isn't it better to maybe just try to apply for another position in the department? I am still in school but I hear so many stories of bitter graduates who cannot find work. I don't want that to be me so I was thinking I would try to get my foot in the door some other way. 

Who Am I?

I've noticed that I get a lot of visits on this website but very few comments. I know that this is an informative platform but I would like for it to also be interactive, thus the "Question of the Day" posts.

Other than my small introduction I realize that you guys don't know much about me. So, I'm posting my resume so you can see who I am professionally.

I enjoy my work in the Health Information Management field and I look forward to the challenges and always appreciate the learning experiences. I have a very friendly yet firm management style. Communication is a focus on my list of priorities and I believe that communication goes both ways when trying to work together as a team. I am a very fast and comprehensive learner and I adjust well to change. I believe that my knowledge and skills are an asset to a hospital that is looking for a solid leader that believes in excellence and loyalty.

Education/Certifications:

University of Mississippi Medical Center; Jackson, MS; Online
Bachelors of Science in Health Information Management/Informatics: Fall 2009 (in progress now)

Hinds Community College; Nursing/Allied Campus, Jackson, MS
Graduated May 2004: Associate of Applied Science in Health Information Technology; Dean Scholar

RHIT:  1/2006 (Attained and current)

Alcorn State University; Alcorn St, MS
Enrolled: 8/1997-12/1998: Nursing Major/Honors College

Experience:

 Director of Health Information Management: 10/2011-Present

I manage all day to day activities for the HIM department as well as 1 FTE for the 54 bed facility. I entered a department that had been without a director for 5 ½ months and during my time there I have worked diligently to lower the delinquency rate, improve the H&P turnaround times, 24 hour verbal and telephone order authentication as well as implement a documentation improvement program. I also serve as the Project Manager for our current EHR implementation. I participate on the Medical Executive Committee, Quality Committee, Utilization Review Committee and Forms Committee.  I have also engaged in student educational contracts with Louisiana Tech University.

 Dallas, TX, Corporate Coder: 4/2011-11/2011

I coded all LTACH encounters for correct and optimum reimbursement with 100% accuracy rate and covered 3 hospitals at the corporate level.

Dallas, TX, Coder II: 11/2009-9/2011

I coded Inpatient encounters for proper and accurate reimbursement with production quotas of 24 per day and 95% accuracy rate.

Fort Worth, TX HIM Manager: 11/2006- 11/2009

I oversaw all HIM functions of a 44-bed Long Term Acute Care Hospital and managed 1 FTE and 1 PTE. Coding all in-patient records with the accuracy of 95-98% was a daily job function. History and Physical turn around time was maintained at 24 hours. I consistently maintained a delinquency rate of ≤ 20%. I also engaged the physicians with education to improve our clinical documentation. I participated in two Joint Commission surveys without “dings” for my department. I also engaged in student educational contracts with Midline Community College.

 Jackson, MS LTC/DRG Coordinator: 7/2006-11/2006

DRG Coordinator for Mississippi Restorative Hospital and Geri-Psych Unit; coded and analyzed all admissions and discharges for the 400+ bed hospital. I handled education for coding and documentation issues concerning physicians.

 Byram, MS Director of Medical Records: 3/2005- 7/2006

88-bed Skilled Nursing Facility, Oversaw and carried out all functions of the medical records department and managed 1 FTE.

 Jackson, MS; Anesthesia Billing and Coding Specialist: 11/2004-3/2005

Using my knowledge of ICD-9-CM, CPT and ASA coding, I coded Operative reports and Anesthesia records for proper reimbursement.

  Jackson, MS Director of Medical Records: 5/2004-11/2004

Oversaw and maintained the daily functions of Medical Records within a 105 bed Long Term Care SNF.

Skills

I am skilled in using ICD-9-CM, CPT, ASA, HCPCS, DRG and RUG categories for reimbursement. I am proficient in Word, Excel, Access, and PowerPoint, CPSI and 3M coding software. I also have experience with HCS Interactant, EPIC Health Record, Clintrac and Horizon Patient Folder.

Memberships:

AHIMA/MSHIMA/TXHIMA Member:  2002-Present

Question of the Day

Question via email:

Hi Julie,

I have just begun my journey in training for a career in medical coding. I have doing a lot of research in the field and stumbled across your YouTube videos. I find them to be extremely informative, and am so grateful that you take the time to share your knowledge with the world.

I have a question. You mentioned that you had received an employment offer from Houston, before you graduated your HIM program. Do you mind sharing the name of the employer? Was it Memorial Hermann? I am a Texas native (San Antonio, TX), and was curious as to which employers would consider entry level certified coders.

Thanks a bunch!

Questions?

I apologize for the late post.

I was wondering if any of you guys had any questions for me? Please feel free to ask in the comment section below and I'll work on answering them in future blog post!

Have a great day!

LTACH...What is it?

I work in the medical setting of a Long Term Acute Care Hospital hence, LTACH. In this type of setting we are able to handle acute patient requiring: mechanical ventilation, complex wound care, long term IV antibiotics, telemetry, dialysis, multiple therapies and critical care. We are able to perform some simple surgical procedures and we have a low level ER.

Most of our patients are here for 25 or more days and some are "frequent flyers". Their medical information, in a paper based setting, can become enormous. I've encountered patients that have a whole row(s) of shelving all to themselves.

I enjoy working in this setting because I get to do some of everything. I code, participate on committees, interact with physicians and other medical staff in addition to my management duties. I also enjoy the size of this type of facility. Some LTACHs have 20-80 beds and might be a part of a larger corporate structure, such as Kindred, Lifecare and Select Specialty hospitals.

In an LTACH setting the HIM department tends to be small and maintained by less than 5 people, depending on the bed size of the hospital. You truly get to be a jack of all trades in the HIM world when you would in an LTACH.

I've really enjoyed my LTACH experience and I've been in this type of setting for 6 years and I actually prefer it. Don't forget to check into the different type of settings when you are exploring your options.

Tried and True

Even though I'm no longer a student (at this moment) I still utilize books from my program and other than a pharmacology book, I've kept all of my books for HIM and I occasionally refer to them.

Yesterday, I needed to gather some statistical numbers for a project and needed a formula that I haven't used in a very long time, Average Daily Census. I thought I knew the formula but the numbers just seemed wrong. So, I pulled out my "Johns" book, checked the index, realized I was not using the correct formula and found the right formula:

         Total patient days of a period / number of days in the period = Average Daily Census

So I encourage you guys to hold on to your books because you never know when you'll need to pull them out.

My Study Guides!

All the Different Views!

There are so many career options in the world of HIM. I believe a lot of people just think of coding, medical records and billing when they think of jobs in the field. Yet, there are so many titles, functions, departments and settings that HIM professionals can occupy.

I will be the first to admit that when I thought about jobs after graduation being a coder was the first thing on my mind and yet, my first job was actually as a Medical Records Manager in a SNF. Now, I was the only person I managed but I also did everything in the department and had full control over how it was ran. My teachers did encourage us to explore all our options and apply for any job we were interested in because you never know what you'll like or where you'll end up.

I'm glad I had that kind of advice and it really paid off because before I graduated I had two job offers to consider, one at an LTACH as a coder and the other as the SNF MR Manager. I made my decision based off the fact that the LTACH position was in Houston and they wouldn't include a relocation package for me and the SNF position was in my home state.

I also encourage you to not only explore job functions but also the different healthcare settings. The HIM world is much bigger than Short Term Acute Care Hospital (STACH). There are doctor offices, nursing homes, SNF, rehabs, psych hospitals, LTACHs, insurance companies, government facilities, software vendors, research facilities, home health agencies and hospices that all require HIM professionals.

To aid in your decision making I encourage you to visit this AHIMA partner site to gain some insight on what you are interested in. But tell me, at this moment, what are you interested in as job function and setting?

Regular Programming

Hey Guys! I'm just returning to work after the recent holidays and I'm super busy but I will return to normal posting on Friday!

My schedule for this blog will be Monday, Wednesday and Fridays. If you have any questions or request please email me at jtb@mississippimulatto.com and I'll be glad to help out.