Write a query that gets a response

Transcription

1 NEW! 2011 Fall Classes Physician Queries TM Write a query that gets a response Boston, MA September Chicago, IL September San Diego, CA October Seattle, WA October Atlanta, GA November Fort Lauderdale, FL December 1 2 REGISTER TODAY! ACDIS MEMBERS SAVE $100! Visit or CALL 800/

2 OOT Hands-on training CAMP on the clinical documentation improvement query process During this interactive two-day Boot Camp, you ll receive the latest on regulations and industry guidance for physician queries, review actual medical records, and learn how to look at the records from an auditor s point of view to decide what needs further clarification. You will craft compliant verbal and written queries that ensure a complete and accurate medical record, minimize RAC risk, and elicit physician response. Individual and small group workshop exercises are designed to give you take-away worksheets you can use to develop or strengthen your program s policies and procedures. Participants should have previous training or experience in clinical documentation improvement. Physician Queries Boot Camp TM See the HCPro difference for yourself. Custom-designed course materials: All course materials are custom-developed specifically for this intensive learning format. Hands-On: You will work in small groups and review actual medical records to receive an authentic experience by formulating queries. Students will learn from our qualified instructors and their peers. Live instruction: All classes are taught by an experienced, highly credentialed instructor. Small Class size: We limit the number of course participants in order to retain a low participant-teacher ratio. This allows us to provide individual instruction as needed when participants find a topic to be particularly challenging. Well-Established Program: Backed by the Association of Clinical Documentation Improvement Specialists (ACDIS), this Boot Camp meets the continuing standard for educational excellence in CDI training.

3 Course Agenda DAY ONE Introductions and Course objectives Physician Queries Industry guidelines and compliance examples AHIMA query guidance OIG/QIO guidance Legal perspective: a case study reviewing non-compliant queries and a false claims settlement Examples of query policies (to be included with materials) Processes versus policies (examples to be included with materials) Query follow up Unanswered queries Query compliance, audits, and corrective action Clinical examples of situations requiring a query Clinical indicators of a diagnosis but no documentation of the condition Clinical evidence for a higher degree of specificity or severity A cause-and-effect relationship between two conditions or organism An underlying cause when admitted with symptoms Only the treatment is documented (without a diagnosis documented) Present on admission (POA) indicator status Developing your query templates Clinical examples with examples of query wording Practicum Individual chart reviews and identification of query opportunities Clarification of a PDx CC or MCC Hospital-Acquired Conditions (HAC) Complications Severity condition Conflicting or contradictory documentation Clinical evidence of undocumented condition Condition needing greater specificity Other clarifications Development of query templates/standardized language (small group activity) Chronic respiratory failure Acute renal failure or AKI Malnutrition Sepsis Urosepsis Stroke Encephalopathy Heart failure Acute MI Free-text diagnosis Presentation and review of group activity query templates Individual activity (each student to develop queries for the opportunities identified during their individual chart reviews) DAY TWO Query presentation Review of Day One individual activity Taking your process to the next step: What are your queries telling you? Evaluating your queries Provider response Sample dashboards/reports Evaluating non-responses and drilling down Developing a process to deliver a 100% response rate Communication of the problem Education No response process or policy Enlistment of support: VPMA, CEO, Medical Advisor Suggestions for enlisting support RAC and the query process Updated RAC targets/diagnoses Examples of RAC denials and appeals Closing the gap: how CDI can minimize RAC risk Suggested processes

4 Practicum Individual chart reviews each student to: Identify conditions/situations in the medical record that might pose a RAC risk List why it s a problem Identify possible solutions or actions If a query opportunity, write the query Verbal queries and provider education Small group activity: Develop a 60-second commercial to introduce yourself to a physician educating him/her about your role as a CDS Develop a verbal query for one (or more) of the conditions identified in your individual chart review Class activity Provider and CDI specialist role play Enactment of verbal query scenarios Evaluations and closing remarks *Agenda subject to change Who should attend CDI specialists CDI managers/directors Coding compliance directors/managers HIM directors Coding compliance specialists DRG coordinators Inpatient coders Coding managers/supervisors Case management directors/managers Revenue cycle directors Physician champions/advisors to CDI Quality improvement professionals RAC coordinators Register Today Visit or CALL 800/ COMMON Questions Are continuing education credits provided? Yes. Visit us at for complete about continuing education credits. The Physician Queries Boot Camp offers continuing education credits from the following organizations: Certified Clinical Documentation Specialist (CCDS) Continuing Medical Education (CME) Nursing Contact Hours (ANCC) California Board of Registered Nursing American Academy of Professional Coders (AAPC) Commission for Case Manager Certification (CCMC) Participants should have previous training or experience in clinical documentation improvement. Note: Class participants are expected to have a grounding in DRGs and ICD-9-CM coding before they take this course. Physician Queries TM

5 Your REGULatorY EXperts Lynne Spryszak, RN, CCDS, CPC-A, is the CDI education director for HCPro, Inc., in Danvers, MA. She is the lead instructor for HCPro s Clinical Documentation Improvement Boot Camp live and online versions. She serves on the board of the Association of Clinical Documentation Improvement Specialists (ACDIS) and is a content developer for the Certified Clinical Documentation Specialist (CCDS) exam. Spryszak is a recipient of the 2009 Recognition of CDI Professional Achievement award from ACDIS. Sylvia Hoffman, RN, C-CDI, CCDS, served as a clinical documentation specialist at Tampa General Hospital in Tampa, FL before starting her own Tampa-based CDI consulting practice. She has 15 years of acute care-hospital based experience and 10 years case management experience. Hoffman was a past-president of the Florida ACDIS regional chapter and is a featured writer for ACDIS Blog. PRAISE FOR OUR INSTRUCTORS... From enthusiastic CDI Boot Camp graduates: Lynne is a valuable, great, knowledgeable instructor. This, by far, trumps all other CDI training I ve attended. Edward Reyes, Regional Assistant Coding Manager, Memorial Medical Center Sutter, Modesto, CA Lynne Spryszak talk about a lady who knows her stuff. Very knowledgeable. Wow. I was very impressed. Becky Parkins, RN, CPC-A, Riverton Memorial Hospital, Riverton, WY Lynne is very knowledgeable about her field, CDI documentation. Very focused and passionate in the way she expresses herself and the attitude towards students. Carlota I Garcia-Styczynski, Revenue Cycle Manager, Rosland Community Hospital, Chicago, IL Sylvia was great. Very informative and helpful. Great instructor. Easy to work with. Mary Silver-Smith, CCS, CCS-P, CPC, CPC-H, CCP-P, KForce, Hampstead, NC Lynne was awesome. She made those of us that were brand new to CDI feel welcome and comfortable with the sometimes overwhelming feeling with change and continued education. Colleen Eichner, RN, Wellstar Hospital System, Austell, GA

6 ADDitionaL services AVaiLABLE Need to train a group? Bring the Physician Queries Boot Camp to your facility! In addition to our open registration classes, we also offer this Boot Camp as an on-site program (with a substantial discount) for organizations that have a number of employees who need training. To explore the possibility of hosting a Physician Queries Boot Camp or to discuss other training programs, call 877/ or bootcamps@hcpro.com. Additional Boot Camps offered by HCPro: Clinical Documentation Improvement Boot Camp Live and Online HCPro ICD-10 Basics Boot Camp Live and Online Certified Coder Boot Camp Inpatient Version Go to or contact us at 800/ Become a member! The Association of Clinical Documentation Improvement Specialists (ACDIS) is a membership association created especially for CDI professionals to bring together people of various backgrounds into one forum. Members share the latest tested tips, tools, and strategies to implement successful CDI programs and achieve professional growth. To join or learn more, visit or call 800/ Demonstrate professional excellence with CCDS certification ACDIS now offers a new certification for CDI specialists, the Certified Clinical Documentation Specialist (CCDS). To learn about prerequisites or to apply, please visit the ACDIS Web site at The HCPRo ICD-10 Basics TM Boot Camp Get ready for the future with HCPro s ICD-10 Basics Boot Camp. It s the right training at the right time! This intensive program will give staff an introduction to the fundamentals of ICD-10 coding. They will learn the differences between ICD-9 and ICD-10 codes, understand major changes to official coding guidelines, and develop the confidence to tackle the new system. Take the class live or online. Visit for more. ACDIS members save $100 off the registration fee. Call 877/ to receive your special discount rate or sign up for membership today!

7 Dates and locations Courses are available across the country and class sizes are limited to guarantee individual instruction. Upcoming dates and locations are listed below. Please visit for hotel. Location Class Dates Boston, MA September Homewood Suites by Hilton-Boston/Billerica, Billerica, MA Schaumburg (Chicago), IL September Hyatt Place Chicago/Schaumburg, Schaumburg, IL San Diego, CA October Homewood Suites by Hilton-San Diego Airport/Liberty Station, San Diego, CA Seattle, WA October Spring Hill Suites Seattle Downtown,Seattle, WA Atlanta, GA November Hyatt Place Atlanta/Perimeter Center, Atlanta, GA Fort Lauderdale, FL December 1 2 Hyatt Place Fort Lauderdale Airport South, Dania Beach, FL Class times are 8:00 a.m. 5:30 p.m. Special Room Rates Available! We have negotiated a special rate for a limited number of rooms at each course location. Rooms are available on a first-come, first-serve basis and may sell out before the cutoff date. Make your hotel reservations immediately to guarantee the hotel rate and availability, and be sure to identify yourself as a participant of HCPro s Physician Queries Boot Camp TM. Course Fee (INCLUDES COURSE MATERIALS) $895 for ACDis members $995 for non-members $995 price includes ACDis one-year membership! For more dates and locations VISIt or CALL 800/

8 Course Registration Form Registration Rates: Registration Rates: $995 Standard Rate $1,699 $995 Price Full includes five-day ACDIS course membership (includes the $995 two-day RAC preparation training) $895 Includes $100 discount for current ACDIS Members $995 Two-day RAC preparation training only Please Please mail mail or or fax fax the the completed form form to: to: HCPro, HCPro, Inc. Inc. 200 PO Hoods Box 3049 Lane Marblehead, Peabody, MA MA Phone: Phone: 800/ Fax: Fax: 800/ Course Location Course Dates Name Nickname Organization Title Address City State ZIP Phone Fax Address Payment Type A check for my course fee is enclosed (made payable to HCPro, Inc.) Charge my course fee to (circle one): Visa VISA MasterCard American American Express Express Discover Name on Card Signature Cardholder Cardholder Street Street Address Address ZIP ZIP Card Number Exp. Date Upon Upon receipt receipt of of this this form form and and your your course course fee, fee, we we will will send send confirmation confirmation of of your your registration, registration, including including hotel hotel and and about about any any manuals/texts manuals/texts required required for for class class (this (this is is also also available available on on our our Web Web site site at at Physician Queries TM 75 Sylvan St., Suite A-101 Danvers, MA MT104322