Transitioning to Itemized Billing in the Military Healthcare System: Are We Ready? Evaluating Outpatient Coding Accuracy in the Walter Reed Army Medical Center General Internal Medicine Clinic PDF Download
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Languages : en
Pages : 0
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Book Description
In a major step towards meeting Health Insurance Potability and Accountability Act (HIPAA) standards, the Military Healthcare System (MHS)plans to implement an outpatient itemized billing system by October 2002. Over the last four years, there have been many different methods and systems used to collect and code outpatient encounter data. The purpose of this project is to evaluate and assess various methods of performing coding in the Walter Reed Army Medical Center (WRAMC) General Internal Medicine Clinic (GIMC)and determine whether current outpatient coding practice and data quality is sufficient for supporting itemized billing. The first part of this study involved a comparison on coding accuracy between providers in 1998 using a bubble sheet to code diagnoses and procedures (Gall, 1998), and the current study using an automated coding system. The results showed a decrease in International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis coding correctness from 66% to 51% and a decrease in the average number of diagnoses recorded per encounter from 2.24 to 1.81. Evaluation and management (E & M) complexity coding accuracy worsened, showing a higher propensity towards over coding, increasing from 37% to 83% over coded. The second part of this study evaluated coding accuracy of a clinic initiative using medical clerks to code directly from provider written documentation. Evaluating and comparing the results using these and other methods of coding is essential to developing the best practices for accurate coding in the MHS. This study provides suggested interventions and process improvements to assist the organization in improving coding accuracy and overall data quality. More importantly, these interventions will help leadership reduce billing risk and remain focused on the core mission of providing quality care to military beneficiaries.
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Category :
Languages : en
Pages : 0
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Book Description
In a major step towards meeting Health Insurance Potability and Accountability Act (HIPAA) standards, the Military Healthcare System (MHS)plans to implement an outpatient itemized billing system by October 2002. Over the last four years, there have been many different methods and systems used to collect and code outpatient encounter data. The purpose of this project is to evaluate and assess various methods of performing coding in the Walter Reed Army Medical Center (WRAMC) General Internal Medicine Clinic (GIMC)and determine whether current outpatient coding practice and data quality is sufficient for supporting itemized billing. The first part of this study involved a comparison on coding accuracy between providers in 1998 using a bubble sheet to code diagnoses and procedures (Gall, 1998), and the current study using an automated coding system. The results showed a decrease in International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis coding correctness from 66% to 51% and a decrease in the average number of diagnoses recorded per encounter from 2.24 to 1.81. Evaluation and management (E & M) complexity coding accuracy worsened, showing a higher propensity towards over coding, increasing from 37% to 83% over coded. The second part of this study evaluated coding accuracy of a clinic initiative using medical clerks to code directly from provider written documentation. Evaluating and comparing the results using these and other methods of coding is essential to developing the best practices for accurate coding in the MHS. This study provides suggested interventions and process improvements to assist the organization in improving coding accuracy and overall data quality. More importantly, these interventions will help leadership reduce billing risk and remain focused on the core mission of providing quality care to military beneficiaries.
Author: Eric E. Poulsen
Publisher:
ISBN:
Category :
Languages : en
Pages : 53
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Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309083435
Category : Medical
Languages : en
Pages : 213
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Book Description
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 416
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Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309113695
Category : Medical
Languages : en
Pages : 202
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Book Description
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
Author: United States. Congress. Senate. Committee on Appropriations. Subcommittee on Defense
Publisher:
ISBN:
Category : United States
Languages : en
Pages : 848
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Author: Paul Starr
Publisher:
ISBN: 9780465079353
Category : History
Languages : en
Pages : 532
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Book Description
Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
Author: Albert C. Hergenroeder
Publisher: Springer
ISBN: 3319728687
Category : Medical
Languages : en
Pages : 386
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Book Description
This comprehensive book thoroughly addresses all aspects of health care transition of adolescents and young adults with chronic illness or disability; and includes the framework, tools and case-based examples needed to develop and evaluate a Health Care Transition (HCT) planning program that can be implemented regardless of a patient’s disease or disability. Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is a uniquely inclusive resource, incorporating youth/young adult, caregiver, and pediatric and adult provider voices and perspectives. Part I of the book opens by defining Health Care Transition, describing the urgent need for comprehensive transition planning, barriers to HCT and then offering a framework for developing and evaluating health care transition programs. Part II focuses on the anatomic and neuro-chemical changes that occur in the brain during adolescence and young adulthood, and how they affect function and behavior. Part III covers the perspectives of important participants in the HCT transition process – youth and young adults, caregivers, and both pediatric and adult providers. Each chapter in Part IV addresses a unique aspect of developing HCT programs. Part V explores various examples of successful transition from the perspective of five key participants in the transition process - patients, caregivers, pediatric providers, adult providers and third party payers. Related financial matters are covered in part VI, while Part VII explores special issues such as HCT and the medical home, international perspectives, and potential legal issues. Models of HCT programs are presented in Part VIII, utilizing an example case study. Representing perspectives from over 75 authors and more than 100 medical centers in North America and Europe, Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is an ideal resource for any clinician, policy maker, caregiver, or hospitalist working with youth in transition.
Author: United States. General Accounting Office
Publisher:
ISBN:
Category : Economics
Languages : en
Pages : 240
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Book Description
Catalog of reports, decisions and opinions, testimonies and speeches.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309489539
Category : Social Science
Languages : en
Pages : 385
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Book Description
The U.S. military has been continuously engaged in foreign conflicts for over two decades. The strains that these deployments, the associated increases in operational tempo, and the general challenges of military life affect not only service members but also the people who depend on them and who support them as they support the nation â€" their families. Family members provide support to service members while they serve or when they have difficulties; family problems can interfere with the ability of service members to deploy or remain in theater; and family members are central influences on whether members continue to serve. In addition, rising family diversity and complexity will likely increase the difficulty of creating military policies, programs and practices that adequately support families in the performance of military duties. Strengthening the Military Family Readiness System for a Changing American Society examines the challenges and opportunities facing military families and what is known about effective strategies for supporting and protecting military children and families, as well as lessons to be learned from these experiences. This report offers recommendations regarding what is needed to strengthen the support system for military families.
