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:
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Category :
Languages : en
Pages : 416
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Author: Daniel W. Gall
Publisher:
ISBN:
Category : Diagnosis related groups
Languages : en
Pages : 0
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The Military Health system (MHS) has implemented a relatively new automated information system to help capture diagnoses, procedures, and insurance data for all ambulatory encounters. This system, recently implemented at Walter Reed Army Medical Center (WRAMC), is called the Ambulatory Data System (ADS). While the current MHS metric for ADS focuses on compliance, the quality of the data has yet to be extensively measured. Hence, the purpose of this project was to statistically analyze the data quality by studying the coding accuracy of International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes, Evaluation and Management (E & M) codes, and insurance indicator codes within the General Internal Medicine Clinic (GIMC) at WRAMC. Interventions to improve the data quality were identified, developed, and implemented during the course of this project. The sensitivities, positive predictive values (PPVs), and the kappa statistics determined from random samples collected before and after the interventions were compared using Chi square analysis (alpha=05). The results showed an increase in overall non-adjusted ICD-9-CM coding rates from 60% to 67% sensitivity, 66% to 73% PPV, and kappa=.18-.36, however, the differences were not significant. E & M coding improved from a poor sensitivity rate of 21% to significantly better rate of 55%. The study also identified a poor level of accuracy concerning the capture of insurance information (kappas=.18 and .16) that conservatively indicated approximately $1.35 million dollars of missed third party collections within the past year. This study provides a model to improve the quality ADS data that may enhance the organization's ability to efficiently and effectively identify clinical process improvements, make sound resource allocation decisions, increase third party collections, and conduct outcomes research.
Author: U.S. Department of Health and Human Services
Publisher: Lulu.com
ISBN: 1794755136
Category : Reference
Languages : en
Pages : 208
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Book Description
Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.
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.
Author: Alfred Goldberg
Publisher: Office of the Secretary, Historical Offi
ISBN:
Category : Architecture
Languages : en
Pages : 330
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Book Description
The most comprehensive account to date of the 9/11 attack on the Pentagon and aftermath, this volume includes unprecedented details on the impact on the Pentagon building and personnel and the scope of the rescue, recovery, and caregiving effort. It features 32 pages of photographs and more than a dozen diagrams and illustrations not previously available.
Author: National Defense University Press
Publisher: NDU Press
ISBN: 1907521658
Category : Psychology
Languages : en
Pages : 529
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Book Description
Includes a foreword by Major General David A. Rubenstein. From the editor: "71F, or "71 Foxtrot," is the AOC (area of concentration) code assigned by the U.S. Army to the specialty of Research Psychology. Qualifying as an Army research psychologist requires, first of all, a Ph.D. from a research (not clinical) intensive graduate psychology program. Due to their advanced education, research psychologists receive a direct commission as Army officers in the Medical Service Corps at the rank of captain. In terms of numbers, the 71F AOC is a small one, with only 25 to 30 officers serving in any given year. However, the 71F impact is much bigger than this small cadre suggests. Army research psychologists apply their extensive training and expertise in the science of psychology and social behavior toward understanding, preserving, and enhancing the health, well being, morale, and performance of Soldiers and military families. As is clear throughout the pages of this book, they do this in many ways and in many areas, but always with a scientific approach. This is the 71F advantage: applying the science of psychology to understand the human dimension, and developing programs, policies, and products to benefit the person in military operations. This book grew out of the April 2008 biennial conference of U.S. Army Research Psychologists, held in Bethesda, Maryland. This meeting was to be my last as Consultant to the Surgeon General for Research Psychology, and I thought it would be a good idea to publish proceedings, which had not been done before. As Consultant, I'd often wished for such a document to help explain to people what it is that Army Research Psychologists "do for a living." In addition to our core group of 71Fs, at the Bethesda 2008 meeting we had several brand-new members, and a number of distinguished retirees, the "grey-beards" of the 71F clan. Together with longtime 71F colleagues Ross Pastel and Mark Vaitkus, I also saw an unusual opportunity to capture some of the history of the Army Research Psychology specialty while providing a representative sample of current 71F research and activities. It seemed to us especially important to do this at a time when the operational demands on the Army and the total force were reaching unprecedented levels, with no sign of easing, and with the Army in turn relying more heavily on research psychology to inform its programs for protecting the health, well being, and performance of Soldiers and their families."
Author: Institute of Medicine (U.S.). Committee on the Governance and Financing of Graduate Medical Education
Publisher:
ISBN: 9780309303552
Category : Medical
Languages : en
Pages : 0
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Book Description
Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.
Author: Wendy M. Troxel
Publisher: Rand Corporation
ISBN: 0833088513
Category : Biography & Autobiography
Languages : en
Pages : 283
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Book Description
Sleep problems can have long-term consequences for servicemembers' health and for force readiness and resiliency. This first-ever comprehensive review of sleep-related policies and programs led to recommendations for improving sleep across the force.
