Avoid Medicare audits
Protect yourself and your hospital from a Medicare audit by documenting carefully and effectively. Auditors look to confirm the presence of “medical necessity.” Use strong action words like:
• Acute or chronic
Remember to support your assessment and plan with a physical exam that demonstrates the findings consistent with your chosen diagnosis.
Timothy N. Brundage, M.D., CCDs is a Certified Clinical Documentation Specialist and Diplomate of the American Board of Internal Medicine.
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by: KEN STACKHOUSE, RN
EmCare Director of Clinical Services
Some administrators feel their entire day is filled with nothing but meetings. Physicians can feel this frustration as well and tend do not want to set established meeting times with administrators because of it. If you’re among those frustrated by “over-meeting,” you might want to consider encounters such as phone calls, hallway visits and pre-and post- meeting tags on meetings – these can be less formal and less intense than traditional meetings.
Advantages of “hallway” meetings:
Disadvantages of “hallway” meetings:
- Quick, easy and informal – they can set people at ease without anticipation of a “difficult” meeting
- Allows for more conversations in a given day, since you can conceivably reach many more people and topics in a day. It’s “guerilla warfare,” much like an E.D. environment!
- Administrators might not be prepared for these encounters
- They can be distractions to what the administrator was previously doing
- The administrator might be distracted thinking about other projects
- There is generally more power and meaning in an established, set, scheduled meeting with the administrator.
Advantages of an established meeting with preset agenda:
- The administrator’s calendar has your name and topic on it, allowing for all involved to be prepared for the discussion
- You are probably more likely to have the administrator’s full, undivided attention
- The administrator will likely be more prepared
- You are sending a message that you value the administrator’s time – this can be very important!
- You are entering into their comfort zone which may allow them to make better decisions
- There is probably more organization to the meeting (especially with a preset agenda). This can better demonstrate your organization skills and professionalism.
- It can be easier to take notes. (Watch administrators during meetings...they generally take notes, which is more difficult to do with hallway conversations or phone calls.)
Keys to success of traditional meetings:
- First, arrive on time. Administrators usually don’t like to wait. Theygenerally also know the value of their medical staff’s time as well and will do everything in their power to show up to your meeting on time themselves.
- The attention span of an administrator can be extremely short. Keep this in mind when determining the length of the meeting, developing the agenda and managing the agenda.
- Know your agenda items: prepare in advance and don’t come in five or ten minutes prior to prepare.
- Have supporting documents and make copies for the administrator. Take notes on key questions and comments from the administrator and follow up on these items
- Manage the meeting to end on time. If you are able to wrap up even five minutes early, you could make the administrator’s day! If you find the meeting is going to run over, wrap it up anyway with a comment like “We are running out of time and I want to value your schedule and I would like to continue this discussion prior to our next meeting. Would you like to make another appointment?” You could be met with a response such as, “No, let’s continue the conversation” or “Yes, let’s set up another time.” The administrator may not express immediate gratitude, but may have a sense of respect for your professionalism.
Once this type of meeting takes place on a regular basis, the hallway type meetings become more effective than before.
About Ken Stackhouse:
With more than 30 years of healthcare experience, Ken Stackhouse has been a Divisional Director of Clinical Services (DDCS) for EmCare since 2007 and currently practices as an emergency department (E.D.) nurse practitioner. Prior to joining EmCare, Ken worked as Director of Patient Care and Emergency Services at Corpus Christi Medical Center in Texas and Director of Emergency Services and EMS at Baylor Regional Medical Center in Grapevine, Tex. He has also held such titles as Director of Day Surgery/Endoscopy, Trauma Coordinator, Staff Registered Nurse (R.N.) and Firefighter/Paramedic.