|
Alta
Partners News & Tips. Information to Improve your Practice |
|
|
Table of Contents:
Alta
Partners Supports Make a Wish
Medicare’s CERT Program & Medical Record Requirements
BWC
Launches Web-Based Training for Medical Providers
CMS
warns medical practices: Beware of faxed requests for practice account
information
Medicare
CCI Edit Updates Are Now Available
How To Deliver Exceptional
Customer Service
A Few More Customer Service Training Tips
Alta
Partners Supports Make a Wish
Each Year, Alta Partner’s
chooses a charity to support. For 2009, Alta Partners has chosen The
Make-A-Wish Foundation®. In doing so,
Alta Partners joined other North East Ohio organizations
at the 17th Annual Walk for Wishes, a 5K walk through the scenic
Cleveland Metroparks Zoo, to raise funds for the Make-A-Wish Foundation®
of Greater Ohio, Kentucky & Indiana, Northeast Ohio Region.
The Make-A-Wish Foundation® is a
non-profit organization that fulfills the wishes of children with
life-threatening medical conditions. Any child over the age of 2 ˝ and
under the age of 18, diagnosed with a life-threatening medical
condition, may qualify for a wish from the Make-A-Wish Foundation®.
Through the efforts of its
employees, their family and friends, Alta Partners raised an amazing
$7,378. In doing so, Alta Partners qualified as a corporate
sponsor, enabling them to fully support a local child’s wish of a
magical family vacation in Walt Disney World. We would like to express
our sincere gratitude for all of those who helped support this great
cause and make a Northeast Ohio child’s dream come true
Medicare’s CERT Program & Medical Record
Requirements
Medicare’s Comprehensive Error Rate Testing (CERT) program continues to
identify several problematic areas with respect to providers' medical
records. As a result, some Medicare Part B payments have been reduced or
denied in their entirety. Findings from the CERT program are also
consistent with ongoing medical review audits conducted separately by
Palmetto GBA.
Please note that this is not an all-inclusive list but does reflect the
majority of documentation issues discovered during the auditing process.
Illegible handwriting is consistently identified as the number one
problem.
Legibility: All handwritten
entries should be completely legible so someone other than the author or
office staff is easily able to read the notation.
Patient Name:
The patient's full name should be present in
the notes. Along with this in the chart entries, some type of unique
identification number corresponding to the Medicare patient is
suggested. This is recommended as many practices have patients with
similar or identical names.
Signatures in Records:
Medicare requires that the individual who
ordered/provided the services is clearly identified in the medical
records. The signature for each entry must be legible and should include
the first and last name and applicable designation, e.g., R.N., D.O.,
M.D
Date of Service:
Each entry's date of service should list the
month, day and year.
Clinical Laboratory, Diagnostic Tests
& X-rays: Valid documentation for
laboratory, diagnostic and x-ray procedures must include not only the
results/findings or an interpretive report, but also written evidence of
the ordering-treating physician’s or NPP’s request for the procedures.
Orders should be descriptive, list diagnoses, the specific procedures
needed, and anatomic sites (when applicable). If a patient requires a
regular regimen of testing due to a specific condition or medication,
include the rationale, frequency and duration.
Generic orders requesting just 'blood work' or 'knee x-ray' alone are
not acceptable. List the specific tests, number/type of views, and
anatomic location.
Faxes & Chart Copies:
Verify the quality of documentation being
sent in response to records requests. Check the orientation (face-up or
face-down) of records placed in a fax or copying machine. Frequently, we
find the copies of the necessary records are of poor quality, needed
portions have been 'cut off' or are completely blank.
For more information, please contact your Alta Partners billing representative @ 440-808-3654.
BWC Launches Web-Based Training for Medical Providers
Web
streaming tutorials guide medical professionals through BWC processes
The Ohio Bureau of Workers’ Compensation (BWC) has launched a series of informational online videos created for BWC’s medical provider network. The videos are intended to orient newly certified medical professionals with BWC’s systems and processes, and to enhance their overall knowledge of the workers’ compensation system.
The nine videos currently available cover a number of topics, including:
- Introduction to Workers' Comp for Medical Providers;
- Completing the First Report of Injury;
- Completing the Physician's Request for Medical Service or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease;
- Completing the Request for Temporary Total Compensation;
- Completing the Physician’s Report of Work Ability;
- Navigating the Medical Providers section of ohiobwc.com and creating an e-account;
- General billing instructions and commonly accepted billing forms;
- Alternative Dispute Resolution & Medical Billing Dispute Overview;
- Frequently Asked Questions.
The videos are available for viewing at
ohiobwc.com.
For information on a specific claim, contact Alta Partners BWC expert, Linda Lash @ 440-808-3713.
CMS
warns medical practices: Beware of faxed requests for practice account
information
The Centers for Medicare & Medicaid Services (CMS) has warned medical practices to be on alert for a fax scam. Individuals posing as Medicare carriers or Medicare Administrative Contractors have been sending faxes to medical groups instructing them to provide account information update within 48 hours to prevent a gap in Medicare payments. The faxes may bear the CMS logo and/or the contractor logo to enhance the appearance of authenticity.
CMS warns all providers to be wary of such fax requests.
Medicare CCI Edit Updates Are Now Available
The
Centers for Medicare & Medicaid Services (CMS) developed the National
Correct Coding Initiative (CCI) to promote national correct coding
methodologies and to control improper coding that leads to inappropriate
payment in Part B claims.
The coding policies developed are based on coding conventions defined in
the:
- American Medical Association’s (AMA’s) Current Procedural Terminology (CPT) Manual
- National and local policies and edits
- Coding guidelines developed by national societies
- Analysis of standard medical and surgical practice and
- Review of current coding practice
The latest package of CCI edits, Version 15.2, became effective July 1, 2009, and includes all previous versions and updates from January 1, 1996, to the present. It is organized in the following two tables:
- Column 1/ Column 2 Correct Coding Edits and
- Mutually Exclusive Code (MEC) Edits
Additional information about CCI, including the current CCI and MEC edits, is available at www.cms.hhs.gov/NationalCorrectCodInitEd.
How To Deliver Exceptional Customer Service
Like in any business,
good customer service is crucial in
healthcare. Good customer service is all about bringing patients back
and about sending them away happy – happy enough to pass positive
feedback about your office along to others. You can have the best
physicians, the latest equipment and the newest office, but unless you
can get your patients to come back, your office won’t be open for long.
The essence of good customer service is forming a relationship with your
patients – a relationship that makes the patient feel at home in your
office- thus creating a “patient centered” environment.
The first step to create a “patient centered” environment is to create a stress free workplace.
Simple Steps to Create a Stress Free Workplace:
SMILE...nothing starts a day off better than a smile
BE POSITIVE- positivity evokes friendliness
BE AWARE-notice things around you-listen to others
BE PROACTIVE and DO NOT REACT-think of how to make things better then DO IT
DON’T TAKE THINGS PERSONALLY-we are not here to judge
SAY THANK YOU-kill them with kindness
We all remember the old adage, first impression make lasting impressions. More often than not, the first impression that your office makes is through a telephone interaction. Assuring that this is a positive experience can go a long way in creating a positive first impression.
Telephone Basics:
- Answer the phone within 2-3 rings-otherwise let someone else get it
- Turn your focus to answering the call-(caller can tell if you are not listening)
- Smile-this will travel through your voice to your caller. Your tone of voice says alot
- Say your greeting-speak professionally not degrading
- Acknowledge the patient/caller
- Listen to the words and motive for patient’s call
- Make a connection with the patient-show them you understand-ask questions
- Find out what plan of action to take
- Make the caller glad they talked to you
- Thank the patient for calling-they are the reason you are here
- Follow up if necessary
Dynamic Listening Technique:
- When dealing with a talkative caller:
- Let the callers talk...then breathe...when they take a breath...
- Say “ok”...if they override your word say “name” let me see if I have this correctly.
- When we interrupt we gain control.
- It is important to have guided questions.
- If you have a chatty Cathy you need to ask questions that start with did? Can? - Have? Will? Is?
- These are close ended questions...need to be answered with a yes or no.
- If you have a caller that is like a rat maze, you need to ask questions like Who? What? When? Why? How?
But even with your best efforts, you will more than likely interact with a rude caller at some point.
WAYS TO win over rude callers
- Give your 5 Star attitude-
*listen-make a personal connection
*tone of voice-keep light-positive-SMILE
*don’t react-don’t take personally
*don’t judge-acknowledge their emotions
*take control-apologize if we have done something wrong
- Agree with their right to complain
- Repeat their words
- Ask how you can help
- Act quickly -take action, call someone or -keep a list of what was stated.
- Thank them for telling you
And finally...FOLLOW UP…….make sure you do what you say you are going to do each and every time. Final impressions mean as much as first impressions.
A Few More
Customer Service Training Tips
1. Reduce the waiting time for appointments.
2. Record missed or cancelled appointments in the patient’s chart.
3. Look for potential safety hazards in all patient areas.
4. Train your staff to use all equipment properly.
5. Maintain a log of when equipment maintenance is performed.
6. Only discuss a patient’s condition with the staff actively involved in caring for that individual and who have a “need to know.”
7. Don’t discuss a patient’s condition in a public area.
8. Explain all risks to a procedure.
9. Have pleasant, caring staff.
10. Don’t send a past due account to collections without understanding why the patient hasn’t paid the bill.
