RACs will STOP requesting medical records until . . .

RAC Pause Refreshes Rural Hospitals—but Other Challenges Still Ahead

Written by Janis Oppelt Created on Thursday, 06 March 2014 11:50

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Brock Slabach

Relief is the best word to describe the reactions from the rural hospital community in relation to the Feb. 21 announcement by the Centers for Medicare & Medicaid Services (CMS) that recovery auditors will stop requesting medical records.

Brock Slabach, vice president of the National Rural Hospital Association (NRHA), joined the March 3 Monitor Monday broadcast and shared the overall reaction of rural hospital leaders and staff in addition to several worrisome challenges ahead.

“NRHA was pleased to hear the decision by CMS to delay the implementation of the program,” he said. “We feel that the challenges that rural hospitals have in many different areas lead to disproportionate burdens on our facilities, and these burdens revolve around several things.”

For rural hospitals as well as non-rural hospitals, fulfilling the RAC’s ADR requests requires time and effort. Processing these requests is “incredibly burdensome” for those who deal with the ADRs and appeals preparation, Slabach noted.

In addition to ever-present cash management problem, there’s the upcoming ICD-10 conversion and meaningful use thresholds, which will also be burdensome for rural hospitals.

“Certainly the reimbursement problems in general that rural hospital have to contend with could lead to a real cataclysm for our facilities,” said Slabach. “The average loss for rural hospital is -7.6 percent … there’s not a lot of margin left to withstand variations in payment for facilities.”

In addition to the fact that cash is tight for critical access hospitals (25 beds or less), PPS hospitals are threatened with the disproportionate share hospital (DSH) reductions that the Affordable Care Act mandated. The Medicare-dependent hospital payment and the low-volume hospital adjustment expire on March 31—less than a month away, and Slabach said that the NRHA is working with Congress to ensure that the program is extended past April 1.

“When we look at the reimbursement cliffs coming up, the news that we are not going to have the RACs intervening with continued processes after February 28 is very, very welcome news to us,” he said. “It’s certainly a silver lining in terms of some of the many grave and pressing problems that we have to face in our rural communities.”

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CLICK HERE FOR MORE INFO  About the Recovery Audit Contractors (RACs) 

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Study: Half of U.S. Healthcare Providers 25% or Less Done With ICD-10 Implementation

Written by Helen Adamopoulos (Twitter | Google+)  | February 19, 2014

Nearly half of U.S. healthcare providers have completed only 25 percent of less of their ICD-10 implementation process, according to a study by Aloft Group, an international brand strategy and marketing execution firm.

Nearly 200 healthcare providers — 75 percent of which were community hospitals — were surveyed. Of the providers studied, 35.4 percent reported they were 25 percent done with the conversion, while 15.3 percent said they hadn't started yet. In 2013, 40.8 percent of those surveyed said they were 25 percent done, and 33.8 percent hadn't gotten started.

The study found 60 percent of providers cited physician buy-in as a conversion obstacle, and 46.1 percent identified lack of time as an issue. Additionally, 39 percent reported financial resources as an obstacle.

Forty-five percent of those surveyed said they don't agree with the American Medical Association's stance that CMS should reconsider the Oct. 1 conversion deadline. Twenty-five percent said they agree with the AMA's position.

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72 "Strange" ICD10 Codes, Illustrated!

"Struck by Orca": 72 ICD-10 Codes, Illustrated

Written by Helen Gregg (Twitter | Google+)  | February 19, 2014

 Lying on blankets at an outdoor concert in Madison, Wis., last July, a group of health IT professionals were on their smartphones, finding and laughing at some of the more unusual and seemingly unnecessary ICD-10 codes.

The idea of making an illustrated children's book using the codes was tossed around that night, says Niko Skievaski, a former Epic employee who currently works with health IT-focused incubator100state in Madison. But it wasn't until last fall that the idea for a book began to take shape.

"Months later, I was at a bar with some people from the [health IT] community, and we got back on the subject of these ridiculous codes, and a possible book, and some people said, 'Hey, I'd do a piece of art for that,'" he says.

As health IT professionals, Mr. Skievaski and the book's contributors are aware of the controversy surrounding the ICD-10 switch and the pressure the looming Oct. 1 deadline is placing on providers. As an incubator, the group is focused on finding ways to improve the U.S. healthcare system through the use of technology.

Finding a way to ease the ICD-10 proved a bit of a stumbling block, as the group struggled to see how the transition would benefit providers. "It was very hard to identify the benefits, except for insurers having better data, but it was easy to identify the ways it seemed ridiculous," says Mr. Skievaski. "Because we couldn't figure out how to help, we decided to bring some humor to the situation.

"This is our way of helping out," he says.

NOW'S THE TIME TO START ICD10 TRAINING!

Timing is no longer a question in ICD-10 training

We're past the point that we can debate the timing of ICD-10 training. Start ICD-10 training now. 

It's that simple.

Maybe actually training clinical staff to document properly and assign the right medical codes is a bit more complicated. 

SEND YOUR NURSES TO RN-CODER ICD10 ACADEMY MARCH 31 - APRIL 4 IN LAS VEGAS! For Details Go To:              www.RN-Coder.com

The American Medical Association's (AMA) ROAD TO 10 has an easy-to-user outline for planning your ICD-10 training. 

Throw in some tips from the Centers forMedicare and Medicaid Services (CMS), you have a really good start.

Identify staff members (including clinical staff ) who need training on ICD-10.  POINT-OF-CARE CODING MEANS:  Coding the procedures & services by clinical staff -- usually nurses -- 

GET STARTED TRAINING NOW -- IT'S NOT TOO EARLY!

This is Really Going to Help!

CMS creates an incredibly useful guide to ICD-10 implementation

The Centers for Medicare and Medicaid Services (CMS) has a websitethat helps small medical practices build an       ICD-10 action plan.

The Road to ICD-10 lets you pick your specialty, practice size, types of vendors and healthcarepayers. It guides you through what you need to know with specific examples of how ICD-10 codes can affect your practice.

If this existed a few years ago, this blog wouldn't have been needed.  There are other resources to help you plan the ICD-10 implementation. But it's hands-on, understandable advice.

This is really going to help.

New RN-Coder Position! Southern California

On 3/4/14 5:46 PM, LaRhonda D. wrote:
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Hi Joyce,

As a part of our continued growth, we are searching for a new Coding Supervisor to join the AppleCare Medical Group team in Buena Park, CA!

The Coding Supervisor functions as first line management for the Coding Department and provides oversight for the staff. Responsibilities entail coding activities within the department that may include: staffing issues, audits, project management, staff development, quality management, as well as training.

 If you or someone you know might be interested, please read on!

Responsibilities include:
•Provides day-to-day supervision of coding staff
•Coordinates staffing assignments for the coding team.
•Conducts clinical documentation training for physicians, physician extenders and office staff and regularly reports results to team and to offices
•Responsible for the performance and effectiveness of designated attestation recapture tools
•Coordinates select chart audit initiatives

Requirements  include:
•Current RN or LVN license in the state of California
•3 or more years of Clinical Nursing experience
•1 or more years of Supervisory/Management experience
•AAPC or AHIMA certification required
•Access to reliable transportation, car insurance and valid CA driver's license

PREFERRED EXPERIENCE:
•Bilingual in Spanish
•Bachelors Degree in Nursing

For more information and to apply directly, please follow this link to the UnitedHealth Group Careers website: http://uhg.hr/CodingSpvrCAlii. Please apply directly through the website and a recruiter will review your resume promptly. You may also reach out to John Haigh at john_haigh@uhg.com with any questions.

You'll greatly improve the health of others. You'll see your ideas come to life. Join us today to start doing your life's best work! (SM)

Thank you,
LaRhonda Dumas
Talent Acquisition - UnitedHealth Group