Week 4 Team Problem

Team 1- Lavatus Windom & Michele Hornick

Helping Hands Hospital has just transitioned into using the

new classification ICD-10. In order to enhance the coding process applications must
be added. After reviewing the needs of the facility, Learning Team has selected
particular applications that will allow the Hospital to function more efficiently. One of
their main needs are improving the efficiency and the speed of coding and billing.
Using a software called Computer Assisting Coding, that uses natural language
processing, scans medical documentation into the EHR and that can identifying key
terminology and suggest codes for a particular treatment or service would definitely
be an asset. It will also push clinicians to become more specific in their
documentation which will allow claims to get paid faster. (AHIMA, 2013) A second
need that the hospital has is to properly select the appropriate code for a diagnosis
and procedure that is being supported by the medical record. Adopting an Encoder
will help make the transition from ICD 9 to ICD 10 easier. This software will allow
them to map codes between each classifications, in turn it can also assist coder to
become more familiar with the new codes. Which can a help in reducing billing
errors that can cost the hospital revenue or overpayment.
In order to make the other two applications effective;
complete, accurate and detailed documentation must be entered. If proper
documentation is captured a hospital can gain reimbursement, improve quality
measure reporting to CMS, and profiling. Improving the accuracy of clinical
documentation can also reduce compliance risks, vulnerability during external
audits, and provide insight into legal quality of care issues. This is why Learning
Tem 1 is selecting Clinical Document Improvement as the third application to will
help them achieve a functional ICD transition. For each application we have selected
vendors that can meet their needs and also provide them on-going training and
support, software updates due to regulatory changes, ease of use, cost,
maintenance and support, policies regarding interfacing with other products.

Computer Assisted
Coding
Vendor 3M Care M*Modal
Healthcare Communications Catalyst
Information Inc.
Systems

Criteria

On-going training X X X
and support
Software updates X X X
due to regulatory
changes
Ease of use X X
Maintenance and X X
support
Policies regarding X
interface with
other products

Encoder
Vendor 3M Optum True Code
Healthcare
Information
System

Criteria
On-going training X X X
and support
Software updates X X X
due to regulatory
changes
Ease of use X X X
Maintenance and X X X
support
Policies regarding X X
interface with
other products
Clinical
Documentati
on
Improvement
System
Vendors 3M Nuances Salar
Healthcare
Information
Systems

Criteria
On-going training X X
and support
Software updates X X X
due to regulatory
changes
Ease of use X X x
Maintenance and X X
support
References
3M Healthcare Solutions. (2015). Retrieved from
http://solutions.3m.com/wps/portal/3M/en_US/Health-Information-
Systems/HIS/Products-and-Services/Products-List-A-Z/CodeRyte-
CodeComplete/.
AHIMA. (2010). Retrieved from
http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_047343.
hcsp?dDocName=bok1_047343.
AHIMA. (2013).
Care Communications Inc. (n.d.). Retrieved from
http://www.carecommunications.com/CAC-consulting.
ICD10 Monitor. (2015). Retrieved from http://www.icd10monitor.com/slideshow/88-
coding-without-encoders-its-happening-again.
MModal. (2015). Retrieved from http://mmodal.com/products-and-services/coding-
service/.
Nuance. (2015). Retrieved from http://www.nuance.com/company/news-room/press-
releases/Nuance-Named-No.1-Vendor-for-End-to-End-CDI-in-Black-Book-
Rating.docx.
Optum. (2015). Retrieved from https://www.optum.com/life-
sciences/data/integrated-data.html.
Salar. (2015). Retrieved from http://www.salarinc.com/company/our-story/.
TrueCode. (n.d.). Retrieved from http://www.trucode.com/products/trucode-encoder-
essentials/.