1. Midway Health System Marion, Ohio Sharon Brown

2. Revenue Cycle Management Team Members Chase Beekman Sharon Brown Brittany Edwards Sharon Goin Sharon Brown

3. Our Mission… Midway Health System’s mission is to provide comprehensive coding quality for productivity improvement, while providing superior patient satisfaction. Our coding process evaluates and identifies areas where improvements are needed. We strive to obtain timely and accurate reimbursement for our customers in lieu of services provided. This is accomplished by practicing the highest level of integrity, compliance and ethical standards. We use up to date resources within our facility for ongoing staff development, the enhancement of the medical revenue cycle management, and optimal reimbursement. Sharon Brown

4. Our Vision… The Health Information Management Department of Midway Health System will strive to deliver correct and complete coding for all medical records and assist in improving the outstanding quality care to all patients. Sharon Brown

5. Main Functions Admitting, patient access management Case management Charge capture Health information management Patient financial services, business office Finance Compliance Information technology Sharon Brown

6. Revenue Cycle Indicators to Analyze Value and volume of discharged, not final billed encounters Number of accounts receivable days Number of bill-hold days Percentage and amount of write-offs Percentage of clean claims Percentage of claims returned to provider Percentage of denials Percentage of accounts-missing documents Number of query forms Percentage of late charges Percentage of accurate registrations Percentage of point-of-service collections for elective procedures Percentage of increased DRG payments due to improved documentation and coding Sharon Brown

7. Coding Compliance Plan Code of conduct Policies and procedures Education and training Communication Auditing Corrective action Reporting Sharon Brown

8. Customers External Customers- end users of our service that work outside of the facility. Patients Physicians Third-party payers Internal Customers- those individuals or departments within the organization to whom we provide a service Employees Administration Registries Sharon Brown

9. Purposes of AHIMA’s Code of Ethics Promotes high standards of HIM practice. Identifies core values on which the HIM mission is based. Summarizes broad ethical principles that reflect the profession's core values. Establishes a set of ethical principles to be used to guide decision-making and actions. Establishes a framework for professional behavior and responsibilities when professional obligations conflict or ethical uncertainties arise. Provides ethical principles by which the general public can hold the HIM professional accountable. Mentors practitioners new to the field to HIM's mission, values, and ethical principles. Sharon Brown

11. Criteria Used for Audit MRN number Date of service Type of encounter ICD-9 diagnoses codes ICD-9 procedure codes CPT-4 procedure codes 1 = correct 0 = incorrect Sharon Brown

12. Sample of Audit Results Sharon Brown

13. ICD-9 Diagnoses Codes (182 Codes) Sharon Brown

14. ICD-9 Procedure Codes (18 Codes) Sharon Brown

15. CPT-4 Codes (127 Codes) Sharon Brown

16. E/M Codes (78 Codes) Sharon Brown

17. Pathology Codes (44 Codes) Sharon Brown

18. Procedure (Surgery) Codes (46 Codes) Sharon Brown

19. Radiology Codes (25 Codes) Sharon Brown

20. References Johns, Merida L., (2011), Health Information Management Technology, An Applied Approach, Chicago, IL, AHIMA http://www.asha.org/uploadedFiles/aud/CustSat11v6n2.pdf http://wiki.answers.com/Q/Who_are_the_external_and_internal_customers_in_health_car ehttp://wiki.answers.com/Q/Who_are_the_external_and_internal_customers_in_health_car e http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_024277.hcsp?dDoc Name=bok1_024277http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_024277.hcsp?dDoc Name=bok1_024277 Sharon Brown