HIM (Health Information Management) Documentation Workflow Analyzer
HIM (Health Information Management) Documentation Workflow Analyzer
HIM (Health Information Management) Documentation Workflow Analyzer is a reporting and analysis tool that allows senior leaders and HIM managers to quickly uncover issues and opportunities related to clinical documentation and coding. The application provides executive level KPI’s, historical performance trending and HIM worklists to improve process visibility and coder productivity.
Features
- Discover trends in coding and clinical documentation timeliness
- Documentation timeliness trending by physician has account level drill through allowing management to hold physicians accountable to documentation polices
- Coding worklists prioritized by issue and last action enables HIM to work more efficiently
- Trending over time allows performance tracking so management can determine the effectiveness of process improvement initiatives
- Application is automatically refreshed as new data is available
Benefits
Benefits Include:
- Create Worklists for HIM: Alert a coder when an outstanding documents has been completed 2) Review aged requests that are still outstanding
- Discover Process Issues in Current DNFB: 1) Determine root cause of DNFB account aging 2) Review accounts by age and balance 3) Uncover documentation trends and delays by physician group or individual physician
Measures
Available Measures Include
- Accounts not Coded: Dollars Outstanding, Volume Outstanding, Average Days Outstanding, Provider, Primary Payer, Location, Unbilled Reason
- Coding Worklist: Coder, Issue, Age, Total Charge Amount, Last Action/ Ready for Review
- Documentation Timeliness: Provider Specialty, Provider, Average Days to Complete Documentation, Volume of Accounts, Account Level Detail
Data Sources
- EMR
- Documentation Module
- Coding Worklist
Background
The intersection of clinical care and revenue cycle functions creates inherent complexity in both accountability and process. Coding processes are dependent on the accuracy and completion of clinical documentation. Errors or delays in the coding process have dramatic implications on the timing and accuracy of claim submission leaving health systems open to the risk of poor financial performance and increased exposure to compliance risks.
Use Cases
- Coding department is missing a document required to complete coding. The coder sends a message to the doctor to complete and sign the document. Rather than manually checking the account every day the tool will flag the account and populate a worklist when the document has been completed.
- DNFB is growing and the HIM manager states that Dr. X consistently takes 90 days or longer to complete documentation. The health system documentation policy states that documents must be completed within 30 days. Administration opens the tool and looks up the physician and sees the same trend. They can then create a performance improvement plan, go to the physician with examples of their delinquent accounts, and compare the physician to the performance of their peers.
Anticipated Improvements
- Increase in Coder productivity
- Reduction in AR Days
- Reduction in Days in DNFB
- Decrease in outstanding/ Delinquent Documentation
