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<<< Back to
eCoastlines |
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“What Do You Mean By That?” How
to motivate your HIM employees by speaking their language!
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Tina Allan
Sales Consultant, The Omnia Group |
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Recovery Audit
Contractors (RAC): Tips to Manage Your Experience |
Patricia Irorere RHIT, CCS
FHIMA 2007-2008 Data Quality Chair
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Update on Florida’s Office of Vital
Statistics Electronic Birth Registration
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Sharon Dover
Quality Assurance Field Coordinator
Florida Office of Vital Statistics
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FHIMA Legislative Committee Update
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Kelly McLendon, RHIA
FHIMA Legislative Co-Chair
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Health Information Technology at
Lake-Sumter Community College |
Brandy Ziesemer, RHIA, CCS
HIM Program Manager, Lake-Sumter Community College
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“What Do You Mean By That?”
How to motivate your HIM employees by speaking their
language!
by: Tina Allan
Sales Consultant, The Omnia Group
When new employees join an HIM staff, their arrival is
typically a most welcome one, as the number of good,
qualified professionals in the industry is limited.
Still, while strong credentials and verified skills
provide some reassurance that you’ve found the right
person for the job, there’s another all-important,
unanswered question that remains: have you found the
right person for your work environment? Recent
graduates might have the latest reimbursement rules
memorized or prove they can code correctly, but can
their persona and work approach mesh with your existing
employees’? Seasoned applicants come with experience,
their own time-tested systems, but will they understand
a boss who utilizes innovative, fresh management
practices?
As your staff grows
and diversifies, it becomes increasingly important to
ensure harmony and team mindedness in the office. And
one of the best ways to do this is to learn how to
communicate effectively with a wide range of
personalities then put your newfound knowledge into
everyday practice. Each person is unique and apt to have
a very different set of ears.
Good communication
among workers can mean the difference between high and
low employee turnover. It increases morale, boosts
productivity and allows for symmetry (as opposed to
clashes) among new hires and existing employees with
disparate perspectives. Good communication also lowers
the risk of unintentional misunderstandings and
unnecessary stress among staff.
All new hires
exhibit behavioral traits that can clue others in on how
to communicate with them effectively; you just need to
learn to decipher those clues! Some traits are typical
of their stage of life or reflective of their
generation. Others are the result of genetic
predispositions or personal preferences.
Recent HIM Grads
They’re finally
able to get paid for doing what they’ve been trained to
do! Most are apt to be proud of themselves, proud of
their career and ready to accommodate your’s and
everyone else’s needs. Stay upbeat and work closely with
them. Watch how they interact with peers. Those who seem
to strike up easy conversations are probably outgoing
and should respond best to frequent praise, perks and
special privileges. Quiet types usually appreciate a
simple, subdued “thank you” or chances to use their
expertise. Don’t put these reserved people in the
spotlight – for any reason.
New graduates often
bring fresh, unique perspectives to the workplace. This
is especially true of those from the Millennial
generation (born 1978 – 1989) as they are the offspring
of Baby Boomers (born 1946 – 1964) who typically
encouraged their progeny to “do their own thing.” Keep
an open mind when listening to their ideas, answers and
concerns.
Millennials tend to
possess a genuine respect for most authority figures,
but they also have an independent streak and can be
forthright. For example, if they complete an assignment
ahead of time, they may ask unabashedly to leave work
early. Try to be as flexible as you can in terms of time
constraints. Reward them with an abbreviated work day on
occasion, if possible.
They gravitate
toward people who are technically savvy and products
that enable them to work better, faster or more
accurately. Don’t hesitate to communicate with them via
email, instant messaging or the cell phone. Doing so can
convey that you and your Millennial worker are of the
same mind, on the same page. And this helps create a
sense of team.
New grads of any
age may have the traits needed to become leaders in your
organization. Be careful though, as it’s easy to mistake
what is merely social assertiveness for a true
take-charge mentality. Don’t make snap judgments. Try
role-playing with an employee before promising to gear
him or her toward management. Behavioral assessments can
also be administered to uncover a person’s potential for
success in authoritative roles.
Seasoned Applicants
Experienced workers
usually are the most sought after, as they come to their
new employer with first hand, well practiced knowledge
about the HIM world. They’ve combined everyday work
responsibilities with skill-honing seminars and sat
through refresher classes on diagnosis and procedure
coding. Keeping them challenged and excited can be
tricky however, as once the novelty of their new work
environment wears off, they’re apt to exhibit at least
some of the apathy that comes with doing the same job
over a period of several years.
Probe into their
professional needs and expectations; keep in mind that
many of them live to work. Tell them how much you value
their expertise.
People with
experience in the HIM world are usually very good at
anticipating others’ expectations and knowing the
standard procedures. But some may voice their opinions
and express their thoughts much more readily than
others. If your newest experienced worker is
surprisingly quiet, don’t assume it’s because he or she
is short on ideas or lacking interest. Introspective
personalities often see no reason to make small talk.
They may share their thoughts when prodded, but
typically in a direct, succinct fashion. Try asking
open-ended questions to encourage two-way conversations,
but remember that clear, concise words from you are what
they generally understand and appreciate.
Your more socially
oriented new employee will be pleased if you ask for her
input or seem genuinely interested in his responses to
your questions. Make it a point to personalize your
communications and allow time for conversations that
might be extensive. If your effusive workers seem easily
distracted by colleagues, seat them away from one
another in low-traffic areas of your office. They’ll
find it easier to concentrate and perhaps settle in more
quickly, become more valuable to you sooner.
Once you uncover
ways to effectively communicate with your new hires,
you’ll find they seem more comfortable, more productive
and more easily motivated. Boost your retention rate!
Don’t assume you’ve made a hiring mistake if an employee
is failing to meet your expectations. It may be just a
matter of learning to speak the same language.
About the author:
Tina Allan is a Sales Consultant with The Omnia Group
located in Tampa, Florida. She conducts workshops,
facilitates training sessions, and advises clients on
how to successfully hire, manage and motivate
employees. Call Tina at 800-525-7117 ext 1227 or email
her at
tallan@omniagroup.com.
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Recovery Audit Contractors (RAC):
Tips to Manage Your Experience
by: Patricia Irorere RHIT, CCS
FHIMA 2007-2008 Data Quality Chair
The RAC program is an ongoing frenzy of
activity for many healthcare organizations in Florida. RAC’s
goal is to investigate and identify any overpayments and
underpayments collected by Medicare. With this program come
numerous challenges to maintain and track medical record
requests along with appeals and denials for coding and
medical necessity.
There are many ways to ease the tension
by streamlining your organization’s processes. Still,
processes are constantly changing; so, flexibility is
imperative to accommodate these changes to improve timely
communication between the RAC and your facility.
Implementation of a RAC team to oversee
these activities is a great first step. The team should
include representatives from Health Information Management
(HIM) operations and coding, compliance, the business
office, reimbursement, clinical documentation and
utilization review. Convene meetings at least monthly to
summarize data, track lost revenue, underpayments or
problems encountered and brain storm new ways to combat
problems related to coding and utilization management
reviews for medical necessity.
Some typical agenda items for the RAC
team meetings include:
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Discussing implementation of process
standards
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Creating a comprehensive tracking system
for requests, appeals, denials and responses using
automation (perhaps within an existing system)
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Presenting an overview of the following
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Total number of requests for records
from RAC
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Total number of denials received
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Dollar amount of denials
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Denials not appealed
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Appeals in process
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Appeals with responses
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Dollar amount recouped for
underpayments
Storing documentation of the team’s
activity on a shared drive serves as another helpful tool.
All the members of the team must have access to this drive.
The share drive is used to store reports, excel documents
concerning RAC activities relating to utilization reviews
and coding, agendas and HIM operations correspondence. Some
examples of the types of information stored consist of:
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spreadsheets with all the requests for records HIM
operations
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spreadsheets with all the appeals, denials and outcomes
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A running list of areas of concern or hot topics
surrounding the reviews
The department can expect an increase
in volume of requests for medical records. Tracking,
photocopying and timely submissions are constant challenges.
The HIM Director can implement several processes to track
all RAC requests. Make a coordinator or other designee
responsible for monitoring all requests and providing status
updates until all the medical records are out the door to
the CMS contractor. The information collected should
include:
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Patient demographics
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Date of request
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Date sent out
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FedEx tracking number
Taking these steps can prepare you in the
event that your facility MEDITE is Upon receives a notice
from RAC stating “no response to medical records request.”
This means that RAC did not receive a response to their
request for the records. Upon receiving such a notice from
RAC, there is the ability to track the package on the FedEx
website using the tracking number and respond to RAC with
the following information:
Sharing the DRG appeals and denials
with the coders at monthly coding meetings serves as
education in order to alleviate future coding mistakes and
enhance learning opportunities.
With RAC slated to go national by 2010,
it is imperative to explore opportunities to learn from our
present processes through education and continuous process
improvement in order to prepare for the future.
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Update on Florida’s Office of
Vital Statistics Electronic Birth Registration
By: Sharon Dover
Quality Assurance Field Coordinator
Florida Office of Vital Statistics
Florida's Office of Vital
Statistics keeps adding hospitals to the list of online
facilities registering births via the Internet. The list
below shows the hospitals online as of September 30, 2007:
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Baptist Medical Center South, 11/06
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Baptist Medical Center Downtown, 1/07
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Baptist Medical Center Beaches, 4/07
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Wuesthoff Memorial, 4/07
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Tallahassee Memorial Healthcare, 5/07
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Wuesthoff Medical Center, 5/07
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NAS Jacksonville, 5/07
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Shands at Alachua General, 5/07
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Baptist Medical Center Nassau, 6/07
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Shands Jacksonville, 7/07
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Glades General, 8/07
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Jupiter Medical Center, 8/07
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Mt. Sinai, 8/07
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Sacred Heart of the Emerald Coast, 9/07
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Plantation General, 9/07
These hospitals’ birth records are entered
via Electronic Birth Registration (EBR)
— birth records that do not have to be forwarded to the
state office then manually keyed into the state database.
The hospital birth registrar enters the data and in real
time, the information is transmitted electronically to the
State Office of Vital Statistics. Mom is able to go by the
health department and pick up her baby’s certification on
her way home from the hospital.
This EBR system is not only operating
successfully in Florida, but also in Nebraska, New Jersey,
Nevada, Ohio, and South Dakota. Florida hospitals are
pleased with the efficiency of the registration process.
Whether using a desktop PC, printer, and signature pad to
enter the birth data, or a mobile cart, equipped with
laptop, printer, and signature pad, the transition from the
hospital’s current system to EBR has been an easy one.
Entering via the Internet and Citrix software keeps EBR from
being an issue as it relates to hospital security and
firewall issues. Social Security Enumeration is much faster,
something parents are quite happy about — they have their
child’s number in a couple of weeks. EBR is available to
hospitals at no charge. With the ease of operation, the
almost immediate transmittal of the data, and elimination of
paper records filed with the county, the system speaks for
itself. EBR is the only avenue for uploading birth data;
Florida will not be utilizing any external systems to upload
data to Vital Statistics.
Jana Duffy, EBR Project Lead, continues to
work with facilities statewide in assessing their processes
and how that translates to the electronic environment. Any
questions regarding EBR should be directed to Jana at (904)
359-6900 ext. 1087 or (904) 524-0311 or
jana_duffy@doh.state.fl.us.
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FHIMA Legislative Committee Update
by: Kelly McLendon, RHIA
FHIMA Legislative Co-Chair
This year FHIMA has divided the Legislative duties into 2
Committee’s; Advocacy, Chaired by Linda Renn and the one I
am serving as Chairman which is primarily tasked with
re-writing the FHIMA Legal Manual and providing support for
legislative issues for all our members. Jill Finklestein is
our BOD liaison. The talented and diverse members of this
committee include:
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Philip Baker
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Michael Lowe, Esquire
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Bill Dillon, Esquire
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Everall Peele
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Elizabeth Whitmer
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Lisa English
This is a very dynamic and
exciting group, including two attorneys who provide us with
invaluable insight. We have reviewed the existing manual
components and would like extend a ‘tip of the hat’ to all
the dedicated FHIMA members who have contributed to this
body of work in previous years, much thanks to all of you!
We look forward to building upon your able foundation.
We are early in our task and
it will take most of the year to complete, but with this
energetic group I know we’ll be successful. The Committee’s
game plan revolves around review and updates of existing
materials, determination of any expansion to include
statutory sections of Florida law such as Section XXX which
addresses physician offices and getting concurrent with LHR
(Legal Health Records) and the new eDiscovery FRCP (Federal
Rules of Civil Procedure). The pervasive movement towards
EHRs (Electronic Health Records) presents challenges and
opportunities in relation to Legal Health Records which
AHIMA and FHIMA recognize and recommend be addressed in a
proactive manner. Watch Coastlines for further discussion on
this topic.
What is a ‘Legal Health Record’?
This is a question that has
a varied set of answers, but for purposes of clarity I like
to think of the LHR in terms of simple and more complex
definitions. The simple definition is the record that serves
as a facilities (or Provider of Care) business record that
will be delivered upon subpoena or other appropriate legal
request. This record (many of us call it ‘the LHR’)
should be well defined. The more complex definition includes
almost all EHR data and documents (along with paper if
existent) that can be discovered in structured steps after
initial disclosure of the defined business record.
In the paper environment it
was simple enough to say that a paper medical record served
as the LHR. In today’s increasingly electronic (and paper /
electronic hybrid) record management environment it gets
harder to clearly define. There are two primary methods
for LHR definition; either a listing of its possible
components (typically consisting of documents) or as
a statements that describes what is contained within a EDM
(Electronic Document Management) or other EHR system(s). For
example; the documents listed in the Master Document Table
within a EDM system which houses the facilities medical
records. Be sure to enumerate exceptions to the list, for
example coding queries and external documents such as copies
from other facilities. These documents may be excluded from
your LHR, yet they still reside within the Master Document
Table.
I’ll write more as the year
progresses on this topic. Stay Tuned! As always if you have
questions or comments please contact me at
kmclendon@go-iem.com
or call me at (321) 268-0320, I’d be happy to chat with
you.
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Health Information Technology at
Lake-Sumter Community College
by: Brandy Ziesemer, RHIA, CCS
HIM Program Manager, Lake-Sumter Community College
The Health Information students held a kick-off for National
HI&T Week. On November 1st, students presented a mock HIT
vendor fair and reception for our Advisory Committee and the
community. Topics included discussion on products available
for converting from paper records to an EHR. The event was
held in the new Science and Math Building on the Leesburg
Campus. Our Laura Clark
memorial HIM Library Collection has a new home in the main
Library on the Leesburg Campus to expose the collection to
more people. Although the books are for in-house reference
only, please feel free to browse through our collection by
signing in to
www.iscc.edu; following the libraries link, then
courses, then Health Information Management. The Laura Clark
collection has a separate link to a visual data base of the
books available.
For more information or to
find a good candidate for your HIM department, please call
Brandy Ziesemer at 352-435-6414 or email
ziesemerb@lscc.edu.
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