Good morning Pam,
My first suggestion is to fix the problem on the front end and then there is no
mess on the back end. We have almost zero cases to fix on the back end. The
Case Managers/Utilization Review staff review every admission/observation case
and enter the clinical findings in the UR module of ABS. We fax EVERY case
whose primary payer is non-Medicare and non-Medicaid. We know before we fax
whether or not the case meets clinical criteria. When we are notified by the
payer that the inpatient case will only be paid at the observation rate, we MOX
mail a notice to Registration (who makes the change in Meditech) and Medical
Records to change the case to observation status. We have LETTERS built in the
UR module with specific instruction relative to the case such as do not change
to inpatient after 24 hours (in hospital policy) unless instructed by case
manager. Our policy addresses the automatic roll-over to inpatient from
observation. Again, the case managers ultimately control the status of the
patient. If the patient is not meeting clinical criteria for inpatient status,
then the case stays observation.
Please feel free to contact me if you have any questions.
Ronald H Kilmer, RN, BS, CPUR
Patient Services Manager
Nathan Littauer Hospital
Gloversville, New York 12078
518-773-5517 Fax 518-775-4005
[EMAIL PROTECTED]
-----Original Message-----
From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Pam
Morgan
Sent: Monday, January 29, 2007 9:17 AM
To: Meditech (E-mail)
Subject: [MEDITECH-L] Obs to In & In to Obs
Questions please--
How are you processing the change from Obs-In or In-Obs on patients
that have already been discharged? Sometimes the acct is final billed/coded
and other are still in UB status.
We are running into a lot of problems because the Patient Access dept
thinks it is the responsibility of Medical Records and Audit Control to resolve
the issue. Medical Records has access to the routine for OBS to IN and IN to
OBS so they can complete the routine. If the acct is already coded/final
billed, Audit Control/Posting has to enter charges, appropriate to the status.
Lots of staff touching the accts and no one wants to be accountable. We know
there has to be a more efficient way to process the status change, while the pt
is still in the hospital.
Any help you can provide, is always, greatly appreciated.
Pam
Pam Morgan, Education Coordinator
Lexington Medical Center
470 Hulon Lane-Business Service Building
West Columbia, South Carolina 29169
803-791-2326
[EMAIL PROTECTED]
"The highest compliment you can pay a customer is to listen."---Tom
Peters
_________________________________
This email and any files transmitted with it may contain PRIVILEGED or
CONFIDENTIAL information and may be read or used only by the intended
recipient. If you are not the intended recipient of the email or any of its
attachments, please be advised that you have received this email in error and
that any use, dissemination, distribution, forwarding, printing, or copying of
this email or any attached files is strictly prohibited. If you have received
this email in error, please immediately purge it and all attachments and notify
the sender by reply email or contact the sender at the number listed above if
one is provided.
=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=*=
To subscribe or unsubscribe to the meditech-l, visit MTUsers.COM.
To check the status of the meditech-l, visit MTUsers.NET.
For help, email [EMAIL PROTECTED]
______________________________________
meditech-l mailing list
[email protected]
http://mtusers.com/mailman/listinfo/meditech-l
