Guest guest Posted January 11, 2012 Report Share Posted January 11, 2012 Jeff: I would stop and consider strongly the idea of outsourcing. First of all, you are hoping to gain the cooperation of your staff -- right? Second, this is/will be/should be an educative process and ongoing -- to fine-tune the practice and the professional growth of the staff. You must have their acceptance of all this IF you want any degree of success. Outsourcing is not a recipe for such success. How would you feel if your boss were to bring in an outsider to shove some medicine down your throat? This hardly enhances your leadership skills. Think about the various talents of your staff. Talk your needs/desires over with the person who has the people skills to get the most willingness out of the others. No nit-pickers -- you need someone who can imagine the wider perspective. Someone who understands the priorities of the practice. It has been years since I was the boss, but -- even in those " older days " -- the younger staff (who are now well into middle age) knew about peer review and chart review and the like. Your staff should have had lots more prep for such activities within their education. You have lots more tools nowadays to utilize to suit yourself and the regs without outsourcing. APTA has lots of info to draw on. And do not get discouraged because this will be slow-going, but it will be suited to your organization. You will be the ones to alter what does not work and keep or fine-tune what does. This also is an opportunity for the staff to appreciate the burden you carry to insure their paycheck. Staff often has no clue of the dangers of sloppy documentation and poor treatment plans to cash flow. Sounds like WORK -- right!! So? Good Luck, Lucy Buckley PT chart reviews Hi Group: I have a relatively small private practice (2 offices, 5 PT’s). With the current healthcare environment, I am considering the idea of outsourcing our chart reviews/audits. Like most, we have been performing them in-house. But I think that I need someone with more specific expertise and experience in this field to effectively do the job. Does anybody have a group or person that they recommend? I have been getting a lot of email information from the PT Compliance Group. Does anyone have experience w them or know anything about this company? Thanks, Jeff Lewandowski PT, DPT, SCS, ATC, MTC Suwanee GA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 11, 2012 Report Share Posted January 11, 2012 Jeff While Lucy makes some very good points, I might take a counter approach to this (and bear in mind that I am NOT a therapist/but I also do not have a vested interest in you outsourcing either). First off, if your clinic is extremely busy, do you want your staff burning more time in an exercise that isn't one of their passions? Second, if your staff is reviewing one another's charts, will working relationships get in the way (i.e., will someone claim that a coworker has an axe to grind with them)? Third, by outsourcing, would you staff be able to treat one more person in their work day and therefore cover the cost of an outsource review? Finally, if you can find someone to review the charts and bring back documented findings, they would be viewed as an outside expert and possibly their findings would be considered impartial. One final note, many electronic medical record packages now come with built in reviews to take care of complaince issues (this wouldn't necessarily help with the substantive portion of your review). In the future you might consider implementing an electronic medical record so that some of the issues are handled daily and thus the review isn't quite as cumbersome. Jim <///>< Re: chart reviews Jeff: I would stop and consider strongly the idea of outsourcing. First of all, you are hoping to gain the cooperation of your staff -- right? Second, this is/will be/should be an educative process and ongoing -- to fine-tune the practice and the professional growth of the staff. You must have their acceptance of all this IF you want any degree of success. Outsourcing is not a recipe for such success. How would you feel if your boss were to bring in an outsider to shove some medicine down your throat? This hardly enhances your leadership skills. Think about the various talents of your staff. Talk your needs/desires over with the person who has the people skills to get the most willingness out of the others. No nit-pickers -- you need someone who can imagine the wider perspective. Someone who understands the priorities of the practice. It has been years since I was the boss, but -- even in those " older days " -- the younger staff (who are now well into middle age) knew about peer review and chart review and the like. Your staff should have had lots more prep for such activities within their education. You have lots more tools nowadays to utilize to suit yourself and the regs without outsourcing. APTA has lots of info to draw on. And do not get discouraged because this will be slow-going, but it will be suited to your organization. You will be the ones to alter what does not work and keep or fine-tune what does. This also is an opportunity for the staff to appreciate the burden you carry to insure their paycheck. Staff often has no clue of the dangers of sloppy documentation and poor treatment plans to cash flow. Sounds like WORK -- right!! So? Good Luck, Lucy Buckley PT chart reviews Hi Group: I have a relatively small private practice (2 offices, 5 PT’s). With the current healthcare environment, I am considering the idea of outsourcing our chart reviews/audits. Like most, we have been performing them in-house. But I think that I need someone with more specific expertise and experience in this field to effectively do the job. Does anybody have a group or person that they recommend? I have been getting a lot of email information from the PT Compliance Group. Does anyone have experience w them or know anything about this company? Thanks, Jeff Lewandowski PT, DPT, SCS, ATC, MTC Suwanee GA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 12, 2012 Report Share Posted January 12, 2012 You can also consider using a non-clinical person(scheduler or someone who may help with paperwork if you have that?) to do an initial run though, and then you follow up for a more clinical review. A non clinical who is trained appropriately can easily spot clerical errors, missing documentation, missing 30 day progress reports, exercise flow sheet that do not appear to support charges rendered, with the clinical person giving the chart a second scan for clinical appropriateness of selected interventions, etc. Still time consuming overall, but can keep it in house, and divides up the work a bit. If you find trends, you target your reviews, and focus on those therapists or interventions that are more problematic. Pierre H. Rougny, PT, OCS, MTC Director of Rehab Services Sebasticook Valley Health 141 Leighton St Pittsfield, Me 04967 , 487-4072(direct line) ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of JHall49629@... Sent: Wednesday, January 11, 2012 1:45 PM To: PTManager Subject: Re: chart reviews Jeff While Lucy makes some very good points, I might take a counter approach to this (and bear in mind that I am NOT a therapist/but I also do not have a vested interest in you outsourcing either). First off, if your clinic is extremely busy, do you want your staff burning more time in an exercise that isn't one of their passions? Second, if your staff is reviewing one another's charts, will working relationships get in the way (i.e., will someone claim that a coworker has an axe to grind with them)? Third, by outsourcing, would you staff be able to treat one more person in their work day and therefore cover the cost of an outsource review? Finally, if you can find someone to review the charts and bring back documented findings, they would be viewed as an outside expert and possibly their findings would be considered impartial. One final note, many electronic medical record packages now come with built in reviews to take care of complaince issues (this wouldn't necessarily help with the substantive portion of your review). In the future you might consider implementing an electronic medical record so that some of the issues are handled daily and thus the review isn't quite as cumbersome. Jim <///>< Re: chart reviews Jeff: I would stop and consider strongly the idea of outsourcing. First of all, you are hoping to gain the cooperation of your staff -- right? Second, this is/will be/should be an educative process and ongoing -- to fine-tune the practice and the professional growth of the staff. You must have their acceptance of all this IF you want any degree of success. Outsourcing is not a recipe for such success. How would you feel if your boss were to bring in an outsider to shove some medicine down your throat? This hardly enhances your leadership skills. Think about the various talents of your staff. Talk your needs/desires over with the person who has the people skills to get the most willingness out of the others. No nit-pickers -- you need someone who can imagine the wider perspective. Someone who understands the priorities of the practice. It has been years since I was the boss, but -- even in those " older days " -- the younger staff (who are now well into middle age) knew about peer review and chart review and the like. Your staff should have had lots more prep for such activities within their education. You have lots more tools nowadays to utilize to suit yourself and the regs without outsourcing. APTA has lots of info to draw on. And do not get discouraged because this will be slow-going, but it will be suited to your organization. You will be the ones to alter what does not work and keep or fine-tune what does. This also is an opportunity for the staff to appreciate the burden you carry to insure their paycheck. Staff often has no clue of the dangers of sloppy documentation and poor treatment plans to cash flow. Sounds like WORK -- right!! So? Good Luck, Lucy Buckley PT chart reviews Hi Group: I have a relatively small private practice (2 offices, 5 PT's). With the current healthcare environment, I am considering the idea of outsourcing our chart reviews/audits. Like most, we have been performing them in-house. But I think that I need someone with more specific expertise and experience in this field to effectively do the job. Does anybody have a group or person that they recommend? I have been getting a lot of email information from the PT Compliance Group. Does anyone have experience w them or know anything about this company? Thanks, Jeff Lewandowski PT, DPT, SCS, ATC, MTC Suwanee GA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 12, 2012 Report Share Posted January 12, 2012 This is a topic we have been struggling with as well, we have consistently done internal, peer and non peer chart reviews. We know what needs to be included in the documentation but with therapist to therapist chart review I fear we are not being hard enough on each other and most of it has to do with the difficulty between individuals of clearly defining what is and isn't considered medically necessary and how best to get that across to the potential reviewer. My Practice Manager has spent a great deal of time and money learning what should and what should not be included in each chart and in turn relaying that knowledge to our staff. We feel that we are adequately supporting our work and I am confident that we have been able to avoid over utilization while still looking out for the best interests of our patients but having heard horror story after horror story from those that have been under review I am not confident that a reviewer would see things as I do. So, for those of you that have outsourced chart reviews, have you found them helpful, have they changed the way you document? And, importantly, does it hold more weight from a potential reviewers standpoint if your documentation has already completed a successful, independent external review? For information sake we utilize incremedical's electronic medical record documentation system. thanks in advance for any advice, suggestions, E. s, PT, DPT Orthopedic Clinical Specialist Fellow American Academy of Orthopedic Manual Physical Therapists www.douglasspt.com > > You can also consider using a non-clinical person(scheduler or someone > who may help with paperwork if you have that?) to do an initial run > though, and then you follow up for a more clinical review. A non > clinical who is trained appropriately can easily spot clerical errors, > missing documentation, missing 30 day progress reports, exercise flow > sheet that do not appear to support charges rendered, with the clinical > person giving the chart a second scan for clinical appropriateness of > selected interventions, etc. Still time consuming overall, but can keep > it in house, and divides up the work a bit. If you find trends, you > target your reviews, and focus on those therapists or interventions > that are more problematic. > > > > Pierre H. Rougny, PT, OCS, MTC > Director of Rehab Services > Sebasticook Valley Health > 141 Leighton St > Pittsfield, Me 04967 > , 487-4072(direct line) > > > > > > ________________________________ > > From: PTManager [mailto:PTManager ] On > Behalf Of JHall49629@... > Sent: Wednesday, January 11, 2012 1:45 PM > To: PTManager > Subject: Re: chart reviews > > > > > > > Jeff > > While Lucy makes some very good points, I might take a counter approach > to this (and bear in mind that I am NOT a therapist/but I also do not > have a vested interest in you outsourcing either). First off, if your > clinic is extremely busy, do you want your staff burning more time in an > exercise that isn't one of their passions? Second, if your staff is > reviewing one another's charts, will working relationships get in the > way (i.e., will someone claim that a coworker has an axe to grind with > them)? Third, by outsourcing, would you staff be able to treat one more > person in their work day and therefore cover the cost of an outsource > review? Finally, if you can find someone to review the charts and bring > back documented findings, they would be viewed as an outside expert and > possibly their findings would be considered impartial. > > One final note, many electronic medical record packages now come with > built in reviews to take care of complaince issues (this wouldn't > necessarily help with the substantive portion of your review). In the > future you might consider implementing an electronic medical record so > that some of the issues are handled daily and thus the review isn't > quite as cumbersome. > > Jim <///>< > > Re: chart reviews > > Jeff: > I would stop and consider strongly the idea of outsourcing. > First of all, you are hoping to gain the cooperation of your staff -- > right? > Second, this is/will be/should be an educative process and ongoing -- to > fine-tune the practice and the professional growth of the staff. > You must have their acceptance of all this IF you want any degree of > success. > Outsourcing is not a recipe for such success. How would you feel if your > boss were to bring in an outsider to shove some medicine down your > throat? This hardly enhances your leadership skills. > Think about the various talents of your staff. Talk your needs/desires > over with the person who has the people skills to get the most > willingness out of the others. No nit-pickers -- you need someone who > can imagine the wider perspective. Someone who understands the > priorities of the practice. It has been years since I was the boss, but > -- even in those " older days " -- the younger staff (who are now well > into middle age) knew about peer review and chart review and the like. > Your staff should have had lots more prep for such activities within > their education. You have lots more tools nowadays to utilize to suit > yourself and the regs without outsourcing. APTA has lots of info to draw > on. And do not get discouraged because this will be slow-going, but it > will be suited to your organization. You will be the ones to alter what > does not work and keep or fine-tune what does. This also is an > opportunity for the staff to appreciate the burden you carry to insure > their paycheck. Staff often has no clue of the dangers of sloppy > documentation and poor treatment plans to cash flow. > Sounds like WORK -- right!! > So? > Good Luck, Lucy Buckley PT > > chart reviews > > Hi Group: > > I have a relatively small private practice (2 offices, 5 PT's). With the > current healthcare environment, I am considering the idea of outsourcing > our chart reviews/audits. Like most, we have been performing them > in-house. But I think that I need someone with more specific expertise > and experience in this field to effectively do the job. Does anybody > have a group or person that they recommend? I have been getting a lot of > email information from the PT Compliance Group. Does anyone have > experience w them or know anything about this company? > > Thanks, > Jeff Lewandowski PT, DPT, SCS, ATC, MTC > Suwanee GA > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2012 Report Share Posted January 13, 2012 My advice is to have an expert either come in and audit your medical records or many consultants will have you send a sample of medical records to them via UPS or Fed Ex and they will audit the charts from their office. The latter is less expensive to you. When I was a hospital administrator, I actually had Kovacek come in and do a full day seminar to my staff even though I was speaking nationally on the same subject matter. In my opinion, it helps to bring in an outside expert. If you would like to talk offline, please feel free to contact me. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. www.gawendaseminars.com Follow Gawenda Seminars & Consulting, Inc on Facebook Register for January 24, 2012 audio conference " 2012 Medicare & Private Payor Updates " at https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1735 Subject: Re: chart reviews To: PTManager Date: Thursday, January 12, 2012, 1:05 PM Â This is a topic we have been struggling with as well, we have consistently done internal, peer and non peer chart reviews. We know what needs to be included in the documentation but with therapist to therapist chart review I fear we are not being hard enough on each other and most of it has to do with the difficulty between individuals of clearly defining what is and isn't considered medically necessary and how best to get that across to the potential reviewer. My Practice Manager has spent a great deal of time and money learning what should and what should not be included in each chart and in turn relaying that knowledge to our staff. We feel that we are adequately supporting our work and I am confident that we have been able to avoid over utilization while still looking out for the best interests of our patients but having heard horror story after horror story from those that have been under review I am not confident that a reviewer would see things as I do. So, for those of you that have outsourced chart reviews, have you found them helpful, have they changed the way you document? And, importantly, does it hold more weight from a potential reviewers standpoint if your documentation has already completed a successful, independent external review? For information sake we utilize incremedical's electronic medical record documentation system. thanks in advance for any advice, suggestions, E. s, PT, DPT Orthopedic Clinical Specialist Fellow American Academy of Orthopedic Manual Physical Therapists www.douglasspt.com > > You can also consider using a non-clinical person(scheduler or someone > who may help with paperwork if you have that?) to do an initial run > though, and then you follow up for a more clinical review. A non > clinical who is trained appropriately can easily spot clerical errors, > missing documentation, missing 30 day progress reports, exercise flow > sheet that do not appear to support charges rendered, with the clinical > person giving the chart a second scan for clinical appropriateness of > selected interventions, etc. Still time consuming overall, but can keep > it in house, and divides up the work a bit. If you find trends, you > target your reviews, and focus on those therapists or interventions > that are more problematic. > > > > Pierre H. Rougny, PT, OCS, MTC > Director of Rehab Services > Sebasticook Valley Health > 141 Leighton St > Pittsfield, Me 04967 > , 487-4072(direct line) > > > > > > ________________________________ > > From: PTManager [mailto:PTManager ] On > Behalf Of JHall49629@... > Sent: Wednesday, January 11, 2012 1:45 PM > To: PTManager > Subject: Re: chart reviews > > > > > > > Jeff > > While Lucy makes some very good points, I might take a counter approach > to this (and bear in mind that I am NOT a therapist/but I also do not > have a vested interest in you outsourcing either). First off, if your > clinic is extremely busy, do you want your staff burning more time in an > exercise that isn't one of their passions? Second, if your staff is > reviewing one another's charts, will working relationships get in the > way (i.e., will someone claim that a coworker has an axe to grind with > them)? Third, by outsourcing, would you staff be able to treat one more > person in their work day and therefore cover the cost of an outsource > review? Finally, if you can find someone to review the charts and bring > back documented findings, they would be viewed as an outside expert and > possibly their findings would be considered impartial. > > One final note, many electronic medical record packages now come with > built in reviews to take care of complaince issues (this wouldn't > necessarily help with the substantive portion of your review). In the > future you might consider implementing an electronic medical record so > that some of the issues are handled daily and thus the review isn't > quite as cumbersome. > > Jim <///>< > > Re: chart reviews > > Jeff: > I would stop and consider strongly the idea of outsourcing. > First of all, you are hoping to gain the cooperation of your staff -- > right? > Second, this is/will be/should be an educative process and ongoing -- to > fine-tune the practice and the professional growth of the staff. > You must have their acceptance of all this IF you want any degree of > success. > Outsourcing is not a recipe for such success. How would you feel if your > boss were to bring in an outsider to shove some medicine down your > throat? This hardly enhances your leadership skills. > Think about the various talents of your staff. Talk your needs/desires > over with the person who has the people skills to get the most > willingness out of the others. No nit-pickers -- you need someone who > can imagine the wider perspective. Someone who understands the > priorities of the practice. It has been years since I was the boss, but > -- even in those " older days " -- the younger staff (who are now well > into middle age) knew about peer review and chart review and the like. > Your staff should have had lots more prep for such activities within > their education. You have lots more tools nowadays to utilize to suit > yourself and the regs without outsourcing. APTA has lots of info to draw > on. And do not get discouraged because this will be slow-going, but it > will be suited to your organization. You will be the ones to alter what > does not work and keep or fine-tune what does. This also is an > opportunity for the staff to appreciate the burden you carry to insure > their paycheck. Staff often has no clue of the dangers of sloppy > documentation and poor treatment plans to cash flow. > Sounds like WORK -- right!! > So? > Good Luck, Lucy Buckley PT > > chart reviews > > Hi Group: > > I have a relatively small private practice (2 offices, 5 PT's). With the > current healthcare environment, I am considering the idea of outsourcing > our chart reviews/audits. Like most, we have been performing them > in-house. But I think that I need someone with more specific expertise > and experience in this field to effectively do the job. Does anybody > have a group or person that they recommend? I have been getting a lot of > email information from the PT Compliance Group. Does anyone have > experience w them or know anything about this company? > > Thanks, > Jeff Lewandowski PT, DPT, SCS, ATC, MTC > Suwanee GA > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2012 Report Share Posted January 13, 2012 My advice is to have an expert either come in and audit your medical records or many consultants will have you send a sample of medical records to them via UPS or Fed Ex and they will audit the charts from their office. The latter is less expensive to you. When I was a hospital administrator, I actually had Kovacek come in and do a full day seminar to my staff even though I was speaking nationally on the same subject matter. In my opinion, it helps to bring in an outside expert. If you would like to talk offline, please feel free to contact me. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. www.gawendaseminars.com Follow Gawenda Seminars & Consulting, Inc on Facebook Register for January 24, 2012 audio conference " 2012 Medicare & Private Payor Updates " at https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1735 Subject: Re: chart reviews To: PTManager Date: Thursday, January 12, 2012, 1:05 PM Â This is a topic we have been struggling with as well, we have consistently done internal, peer and non peer chart reviews. We know what needs to be included in the documentation but with therapist to therapist chart review I fear we are not being hard enough on each other and most of it has to do with the difficulty between individuals of clearly defining what is and isn't considered medically necessary and how best to get that across to the potential reviewer. My Practice Manager has spent a great deal of time and money learning what should and what should not be included in each chart and in turn relaying that knowledge to our staff. We feel that we are adequately supporting our work and I am confident that we have been able to avoid over utilization while still looking out for the best interests of our patients but having heard horror story after horror story from those that have been under review I am not confident that a reviewer would see things as I do. So, for those of you that have outsourced chart reviews, have you found them helpful, have they changed the way you document? And, importantly, does it hold more weight from a potential reviewers standpoint if your documentation has already completed a successful, independent external review? For information sake we utilize incremedical's electronic medical record documentation system. thanks in advance for any advice, suggestions, E. s, PT, DPT Orthopedic Clinical Specialist Fellow American Academy of Orthopedic Manual Physical Therapists www.douglasspt.com > > You can also consider using a non-clinical person(scheduler or someone > who may help with paperwork if you have that?) to do an initial run > though, and then you follow up for a more clinical review. A non > clinical who is trained appropriately can easily spot clerical errors, > missing documentation, missing 30 day progress reports, exercise flow > sheet that do not appear to support charges rendered, with the clinical > person giving the chart a second scan for clinical appropriateness of > selected interventions, etc. Still time consuming overall, but can keep > it in house, and divides up the work a bit. If you find trends, you > target your reviews, and focus on those therapists or interventions > that are more problematic. > > > > Pierre H. Rougny, PT, OCS, MTC > Director of Rehab Services > Sebasticook Valley Health > 141 Leighton St > Pittsfield, Me 04967 > , 487-4072(direct line) > > > > > > ________________________________ > > From: PTManager [mailto:PTManager ] On > Behalf Of JHall49629@... > Sent: Wednesday, January 11, 2012 1:45 PM > To: PTManager > Subject: Re: chart reviews > > > > > > > Jeff > > While Lucy makes some very good points, I might take a counter approach > to this (and bear in mind that I am NOT a therapist/but I also do not > have a vested interest in you outsourcing either). First off, if your > clinic is extremely busy, do you want your staff burning more time in an > exercise that isn't one of their passions? Second, if your staff is > reviewing one another's charts, will working relationships get in the > way (i.e., will someone claim that a coworker has an axe to grind with > them)? Third, by outsourcing, would you staff be able to treat one more > person in their work day and therefore cover the cost of an outsource > review? Finally, if you can find someone to review the charts and bring > back documented findings, they would be viewed as an outside expert and > possibly their findings would be considered impartial. > > One final note, many electronic medical record packages now come with > built in reviews to take care of complaince issues (this wouldn't > necessarily help with the substantive portion of your review). In the > future you might consider implementing an electronic medical record so > that some of the issues are handled daily and thus the review isn't > quite as cumbersome. > > Jim <///>< > > Re: chart reviews > > Jeff: > I would stop and consider strongly the idea of outsourcing. > First of all, you are hoping to gain the cooperation of your staff -- > right? > Second, this is/will be/should be an educative process and ongoing -- to > fine-tune the practice and the professional growth of the staff. > You must have their acceptance of all this IF you want any degree of > success. > Outsourcing is not a recipe for such success. How would you feel if your > boss were to bring in an outsider to shove some medicine down your > throat? This hardly enhances your leadership skills. > Think about the various talents of your staff. Talk your needs/desires > over with the person who has the people skills to get the most > willingness out of the others. No nit-pickers -- you need someone who > can imagine the wider perspective. Someone who understands the > priorities of the practice. It has been years since I was the boss, but > -- even in those " older days " -- the younger staff (who are now well > into middle age) knew about peer review and chart review and the like. > Your staff should have had lots more prep for such activities within > their education. You have lots more tools nowadays to utilize to suit > yourself and the regs without outsourcing. APTA has lots of info to draw > on. And do not get discouraged because this will be slow-going, but it > will be suited to your organization. You will be the ones to alter what > does not work and keep or fine-tune what does. This also is an > opportunity for the staff to appreciate the burden you carry to insure > their paycheck. Staff often has no clue of the dangers of sloppy > documentation and poor treatment plans to cash flow. > Sounds like WORK -- right!! > So? > Good Luck, Lucy Buckley PT > > chart reviews > > Hi Group: > > I have a relatively small private practice (2 offices, 5 PT's). With the > current healthcare environment, I am considering the idea of outsourcing > our chart reviews/audits. Like most, we have been performing them > in-house. But I think that I need someone with more specific expertise > and experience in this field to effectively do the job. Does anybody > have a group or person that they recommend? I have been getting a lot of > email information from the PT Compliance Group. Does anyone have > experience w them or know anything about this company? > > Thanks, > Jeff Lewandowski PT, DPT, SCS, ATC, MTC > Suwanee GA > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 13, 2012 Report Share Posted January 13, 2012 My advice is to have an expert either come in and audit your medical records or many consultants will have you send a sample of medical records to them via UPS or Fed Ex and they will audit the charts from their office. The latter is less expensive to you. When I was a hospital administrator, I actually had Kovacek come in and do a full day seminar to my staff even though I was speaking nationally on the same subject matter. In my opinion, it helps to bring in an outside expert. If you would like to talk offline, please feel free to contact me. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. www.gawendaseminars.com Follow Gawenda Seminars & Consulting, Inc on Facebook Register for January 24, 2012 audio conference " 2012 Medicare & Private Payor Updates " at https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1735 Subject: Re: chart reviews To: PTManager Date: Thursday, January 12, 2012, 1:05 PM Â This is a topic we have been struggling with as well, we have consistently done internal, peer and non peer chart reviews. We know what needs to be included in the documentation but with therapist to therapist chart review I fear we are not being hard enough on each other and most of it has to do with the difficulty between individuals of clearly defining what is and isn't considered medically necessary and how best to get that across to the potential reviewer. My Practice Manager has spent a great deal of time and money learning what should and what should not be included in each chart and in turn relaying that knowledge to our staff. We feel that we are adequately supporting our work and I am confident that we have been able to avoid over utilization while still looking out for the best interests of our patients but having heard horror story after horror story from those that have been under review I am not confident that a reviewer would see things as I do. So, for those of you that have outsourced chart reviews, have you found them helpful, have they changed the way you document? And, importantly, does it hold more weight from a potential reviewers standpoint if your documentation has already completed a successful, independent external review? For information sake we utilize incremedical's electronic medical record documentation system. thanks in advance for any advice, suggestions, E. s, PT, DPT Orthopedic Clinical Specialist Fellow American Academy of Orthopedic Manual Physical Therapists www.douglasspt.com > > You can also consider using a non-clinical person(scheduler or someone > who may help with paperwork if you have that?) to do an initial run > though, and then you follow up for a more clinical review. A non > clinical who is trained appropriately can easily spot clerical errors, > missing documentation, missing 30 day progress reports, exercise flow > sheet that do not appear to support charges rendered, with the clinical > person giving the chart a second scan for clinical appropriateness of > selected interventions, etc. Still time consuming overall, but can keep > it in house, and divides up the work a bit. If you find trends, you > target your reviews, and focus on those therapists or interventions > that are more problematic. > > > > Pierre H. Rougny, PT, OCS, MTC > Director of Rehab Services > Sebasticook Valley Health > 141 Leighton St > Pittsfield, Me 04967 > , 487-4072(direct line) > > > > > > ________________________________ > > From: PTManager [mailto:PTManager ] On > Behalf Of JHall49629@... > Sent: Wednesday, January 11, 2012 1:45 PM > To: PTManager > Subject: Re: chart reviews > > > > > > > Jeff > > While Lucy makes some very good points, I might take a counter approach > to this (and bear in mind that I am NOT a therapist/but I also do not > have a vested interest in you outsourcing either). First off, if your > clinic is extremely busy, do you want your staff burning more time in an > exercise that isn't one of their passions? Second, if your staff is > reviewing one another's charts, will working relationships get in the > way (i.e., will someone claim that a coworker has an axe to grind with > them)? Third, by outsourcing, would you staff be able to treat one more > person in their work day and therefore cover the cost of an outsource > review? Finally, if you can find someone to review the charts and bring > back documented findings, they would be viewed as an outside expert and > possibly their findings would be considered impartial. > > One final note, many electronic medical record packages now come with > built in reviews to take care of complaince issues (this wouldn't > necessarily help with the substantive portion of your review). In the > future you might consider implementing an electronic medical record so > that some of the issues are handled daily and thus the review isn't > quite as cumbersome. > > Jim <///>< > > Re: chart reviews > > Jeff: > I would stop and consider strongly the idea of outsourcing. > First of all, you are hoping to gain the cooperation of your staff -- > right? > Second, this is/will be/should be an educative process and ongoing -- to > fine-tune the practice and the professional growth of the staff. > You must have their acceptance of all this IF you want any degree of > success. > Outsourcing is not a recipe for such success. How would you feel if your > boss were to bring in an outsider to shove some medicine down your > throat? This hardly enhances your leadership skills. > Think about the various talents of your staff. Talk your needs/desires > over with the person who has the people skills to get the most > willingness out of the others. No nit-pickers -- you need someone who > can imagine the wider perspective. Someone who understands the > priorities of the practice. It has been years since I was the boss, but > -- even in those " older days " -- the younger staff (who are now well > into middle age) knew about peer review and chart review and the like. > Your staff should have had lots more prep for such activities within > their education. You have lots more tools nowadays to utilize to suit > yourself and the regs without outsourcing. APTA has lots of info to draw > on. And do not get discouraged because this will be slow-going, but it > will be suited to your organization. You will be the ones to alter what > does not work and keep or fine-tune what does. This also is an > opportunity for the staff to appreciate the burden you carry to insure > their paycheck. Staff often has no clue of the dangers of sloppy > documentation and poor treatment plans to cash flow. > Sounds like WORK -- right!! > So? > Good Luck, Lucy Buckley PT > > chart reviews > > Hi Group: > > I have a relatively small private practice (2 offices, 5 PT's). With the > current healthcare environment, I am considering the idea of outsourcing > our chart reviews/audits. Like most, we have been performing them > in-house. But I think that I need someone with more specific expertise > and experience in this field to effectively do the job. Does anybody > have a group or person that they recommend? I have been getting a lot of > email information from the PT Compliance Group. Does anyone have > experience w them or know anything about this company? > > Thanks, > Jeff Lewandowski PT, DPT, SCS, ATC, MTC > Suwanee GA > > Quote Link to comment Share on other sites More sharing options...
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