Download Presentation 1 - Health Care Compliance Association

Watch Your P’s and Q’s:
Coding and
Documentation
Presented by:
Georgette Gustin,
CPC, CCS-P, CHC
PricewaterhouseCoopers
HCCA Compliance Institute
New Orleans - April 28, 2003
Watch or Mind Your P’s and Q’s….
™ 50 year-old meaning
™ Described as “to mind one’s manners”
and “to behave properly”
™ “The careful exact or prudent behavior”
™ “Just mind your please and thank-you’s”
™ Incorporating concept into coding and
compliance issues through
¾ Behavior; and
¾ Communications.
2
Today’s Discussion
™ Relationships
™ Coder/Physician Communication
™ Types of Communication
¾ Communication Styles Matter
™ Common Reactions
¾ Tips for Dealing with with Coding and
Documentation Issues
¾ Communicating Coding and Documentation
Issues
™ Helpful Hints
¾ Word Selection Tips
™ Tricks of the Trade
3
Relationships
Dependent upon the senders role and needs, the
relationship and communication process will differ
¾ Coder or Compliance Analyst/Auditor
¾ Educator/Trainer
¾ Compliance Officer
¾ Administrator
¾ Business Office
¾ Chief/Department Chair
¾ Utilization Review/Case Managers
¾ Health Information Management
(HIM) Department
4
Coder/Physician Communication
™ Finding and establishing the communication
link is critical to:
¾ Documentation
¾ Compliance
¾ Reimbursement
™ Recognize the language differences
¾ Clinical
¾ Technical
™ Establish processes to overcome barriers
¾ Develop the appropriate approach
¾ Build Trust
¾ Facilitate access
¾ Provide tools/resources
¾ Establish routine/schedule
¾ Implement feedback and monitoring processes
5
Types of Communication
™ Verbal
¾ Orders/Instructions
¾ Voicemail
¾ Education
™ Written
¾ Documentation
– Memo’s
– E-mail
– Policies/Procedures
– Medical Records
– Physician Orders
– Prescriptions
6
Communication
™ Communication requires:
¾ Sender
¾ Receiver
™ Communication can be:
¾ Misunderstood
¾ Misinterpreted
¾ Omitted
¾ Corrected
™ Communication can:
¾ Determine outcomes
¾ Improve teamwork
¾ Impact results
¾ Create lasting images
¾ Impact Patient Safety
¾ Impact Coding & Compliance
7
Communication Style Matters
How do you communicate with your
physicians or others on coding and
documentation related matters?
™ “Let me Hear your Body Talk”
™ “Words can’t Bring me Down”
™ “Killing me Softly with his Song”
8
Common Reactions:
Coding/Documentation Issues
™ “No one is going to tell me what I can code.” I did the
work, it’s my money!”
™ “I just want to take care of my patient’s, this is all
red-tape that frankly I don’t have time to deal with”
™ “This is not my problem its yours, I need to take care
of patients”
™ “The rules are complex and burdensome
and are no benefit to me or to my patients”
™ “I understand why we have to do this,
just help me to streamline the process”
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Tips for Dealing with
Coding/Documentation Issues
™ Develop a Mantra: “Think before you Speak”
™ Understand and anticipate what
stage you might be dealing with:
¾ Denial
¾ Anger
¾ Bargaining
¾ Depression
¾ Acceptance
™ Be prepared, don’t waste time,
be specific & get to the point
10
Communicating:
Coding/Documentation Issues
Avoid Negative Body Language
™ Submissive, closed
and defensive
™ Aggressive, closed
and attacking
¾ Wobbly voice
¾ Hard voice
¾ Slow speech
¾ Rapid speech
¾ Worried expression
¾ Extremes of expression
¾ Evasive look-downs
¾ Excessive/no eye contact
¾ Defensive arms/legs
¾ Dominate posture
¾ Mouth covered with hand
¾ Finger jabbing/wagging
¾ Excessive distance
¾ Invasion of personal space
11
Helpful Hints
™ Select your words carefully and really listen (empathetically)
™ Most important words in our language
¾ 6 words: “I admit I made a mistake.”
¾ 5 words: “You did a good job.”
¾ 4 words: “What is your opinion?”
¾ 3 words: “Let’s work together.”
¾ 2 words: “Thank you”
¾ 1 word: “We.”
™ Be sure you are speaking the same “language”
™ Employ some of Stephen R. Covey’s…
¾ “The Seven Habits of Highly Effective People”:
–
–
–
–
–
–
–
Seek first to understand before you can be understood
Think “Win-Win”
Begin with the End in Mind
Be Proactive
Synergize
Put first things first
Sharpen the Saw
12
Word Selection Tips
Word Selection: Negative vs. Positive
™ Positive Comments
™ Negative Comments
¾ Perhaps I haven’t explained
myself
¾ You don’t understand
¾ It isn’t my fault
¾ We’ve always done it this way
¾ To resolve it we need to…
¾ How should I know…they
never tell me anything around
here
¾ How would you like to see
it done?
¾ I’ll find out
¾ I just don’t have enough time
¾ I need to prioritize my tasks
and do the most important
ones first
13
Tricks of the Trade
™ Build a partnership
™ Be patient, reasonable and consistent
™ Persevere
™ Keep a Positive Mental Attitude
™ Set goals
™ Reward and recognize
positive change
™ Demonstrate value
™ Share Best Practices
™ Never preach or
be condescending
14
Questions & Answers
Georgette Gustin, CPC, CCS-P, CHC, Director
Healthcare Consulting Practice
(317) 860-2131
e-mail: [email protected]
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