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We have a few providers who are not completing their dictation timely. We are working on rewriting our policy on delinquent dictation. In the process our CEO came up with a few things he would like me to research.
1) Is there a way to highlight documents on a desktop that are a specific number of days old? I showed him how we could manually set the priority level but he wants something more automated.
2) Does someone have a report that would list all providers who have an incomplete document greater than "15" and/or "30" days? We have reports that we currently pull to determine this but he would like something more straightforward that takes less employee time. He wants a simple report that just lists the providers who are delinquent.
3)Does anyone have any resources that would show(preferably in graphs) the effects of untimely dictation? Specifically the increased amount of time it takes to complete dictation when it is not done timely. Or the accuracy of untimely dictation compared to dictation that was done timely.
Posted : January 28, 2019 9:47 am
Back in the day, I ran two similar reports for our residency programs. They probably need a bit of work to update but it might get you started. These are in Crystal format and based on the EMR version of the system.
These reports were useful, however, there must be a degree of enforcement along with them which includes education.
Fact is: Most insurance carriers and Medicare/Medicaid (CMS) REQUIRE that documentation be completed prior to the patient leaving (visit conclusion). While not often enforced unless discovered during a 'surprise audit', the premise is simple - documentation is an integral portion of the reimbursement charge which undoubtedly will be charged that day. Who pays in advance and in full for a service anymore?
One solution is to not charge the visit until the documentation is completed, if your carriers will allow it. The reports will mean more if the provider's salary is penalized for each unfinished document (no money in to the practice means no money in the providers pocket). If providers receive less pay for routinely late work (justified by wasted staff hours trying to get them to do their jobs), they tend to self correct rather quickly. I realize this is a very hard sell, but it works and often has a house cleaning effect in the long run and commonly in several unanticipated ways than the obvious.
But there is also a side that is rarely discussed. Providers are busier than ever these days and, yes, contrary to what the ego may claim, their memories are fallible (why else must they see lab normal ranges all the time <grin>). No one can recall with accuracy the details of a visit days later. The further out from the visit, the more detail is lost. There comes a point where 'train of thought derails in the fog' and that puts care quality and patient safety at risk - which in turn puts the practice at risk. I refer you back to my original message regarding using pay as a tool. Money talks.
Posted : January 29, 2019 3:54 am
