Health Information Management
Health Systems Management Network, Inc. provides a comprehensive
Operational Review of every aspect of Health Information Management.
Some of the steps HSMN takes to perform the review include:
- Determining whether HIM (medical records) supports the hospitals
basic mission: patient care.
- Examining the role played by HIM in making sure clinical data
are available to providers in every one of the hospital's settings.
- Reviewing documentation to assure that it supports the level
of service being billed.
- Making rounds with Medical staff members to gain a complete
understanding of Practice and Practice Guidelines
that they are most comfortable using.
- Working with medical staff on reviewing cases, translating the
clinical encounter into the coding language easily understandable
and translatable to supporting the hospital's revenue stream.
HSMN works closely with each specialty.
- Using those opportunities with the medical staff to evaluate
their E & M coding to be certain that - from a compliance point
of view - the patient, in documentation, is represented without
disparities often seen between hospital facility and professional
fee billing coding.
- Examining all processes, procedures and workflows to assure
they are supportive of the main users.
- HSMN reviews include the organizational structure, the leadership, staffing, and skill levels
- Evaluating clinician requirements for data and often designing
the specification for what is needed in an electronic record format.
While we understand the need of hospitals to buy complete systems,
we focus on those specifications that will be most useful to the
clinical staff and ultimately support the hospital's revenue flow.
HSMN's experienced staff is also qualified to provide Interim management
in this field as well as any other field in which HSMN provides
consulting.
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APC
Assessment
AR Outsourcing
Case Management
Cash Acceleration
Charge Master Review
Coding
Credit Balance Resolution
Denied Claims Management
Documentation
Practice Assessment
DRG/Case
Mix
Electronic
Medical Records |
Evaluation and Management
Interim
Management
Medical Necessity
Medical
Records
Medical
Staff Relationships
MIS
Consulting
Operational
Assessment
QA
/ UR
Revenue
Cycle Partnerships
Training
/ Knowledge Transfer
Web-based
Training |
Health Systems Management Network (HSMN) is celebrating its twentieth anniversary providing Hospitals, their medical staffs and Physician practices with the tools and processes essential to improvements in Clinical Documentation Performance (CDP). Clinical Documentation Performance is the critical element in facing the challenges of the new APR-DRG scenario.
The new challenge is one which no electronic system alone can solve. Sound clinical judgment articulated in well thought out supporting documentation is the key the the challenge that will be presented by CMS. CMS and other payors will be challenging clinicians to clearly identify the severity/acuity of the patient relative to the diagnosis. You may ask, “isn’t this what we are supposed to be doing now”? Until now the logic which drives the DRG’s and APC’s have relied on categorization; the new approach will require precision, logical thinking and judgments that correspond to the severity and use of resources in order to be eligible for the optimum reimbursement.
The Medical staff often rebel at being second guessed on their diagnosis or clinical judgment. That is not what the new system is trying to do. It will attempt to make a perfect match between resources and reimbursement. For over twenty years, HSMN has pioneered tools and processes to support the Medical staff and the facility in the arduous task of documentation. Our staffs work directly with practitioners and all departments working in the revenue cycle. From admission through final bill we make sure that appropriate processes, organization, systems and people are ready to meet the new challenge.
Contact: Cathy@HSMN.com
866-908-4226
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