Residency program - Billing / moonlighting
Started by zyprexaoverlord
i'm not sure about billing but EMRA Match lets you search based on moonlighting:
http://match.emra.org/index.php?fuseaction=searchResidency
http://match.emra.org/index.php?fuseaction=searchResidency
At our hospital, EM and Psych are the only two departments operating in the black - $3.6 million in to support the other $4 million out. We have coders who review our charts and e-mail us based on level of service. Requirements for level 1-5 charts are posted in each resident workroom. Billable procedure smartphrases are built into our EMR.
If you mean something different besides that sort of documentation supervision....
If you mean something different besides that sort of documentation supervision....
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D
deleted109597
Whomever you work for that is there to earn money (ie not your residency) will teach you how to bill. If your residency already does that, you'll save about 1 hour of orientation over the rest of your life.
If you already document a level 5 chart (including the damn family history now) consistently, it takes very little to modify your system to meet your employer's needs. However, if you come out of residency with poor documentation skills then it can take months to undo the bad habits you've learned.
I've been out and practicing for over 3 years. I learned the ins and outs of billing in detail during residency, in the form of self-initiated study that eventully took form into a research project. I practice in a group of over 40 physicians, the vast majority of which do not have any comprehension of what a CPT code is, what the physical exam requirements are for a level 3 vs 5 chart, and how to properly document a procedure in order to get paid... and this at a group that is all productivity based! Our own directors are lacking in the proper knowledge.
Learning this during residency will be one of the most important non-medical skills you can acquire. I highly recommend you take a course... ACEP offers a few during the scientific assembly, and a more involved one a few times a year. I took a 2 day course by James Blakeman that was fantastic.
Tampa General Hospital has a great residency for teaching you about billing and documentation.
D
deleted109597
Documentation is different. I strongly believe every chart should be level 5, unless something like suture removal/wound check. It really isn't that hard with EMR to ask your 10 ROS questions, and be able to listen to heart, lungs, abdomen, and pick out the others from just a cursory glance (mucus membranes, neck full ROM, pupils equal, able to converse, neuro grossly intact, etc). Hell, I can document a level 4 standing at a door without ever touching someone.
But billing, that's up to the coders. Nobody will ever tell you E codes, V codes, etc. Just put as many diagnoses as you can think of. Someone well versed in ICD 9/10 will be much better at it than you ever will.
Truthfully, at most places, someone other than you should scribe in PMH, PSH, SH, and FH. At the place I moonlight, the nurses do it. Yeah, I ask it to make sure something isn't missed, but I don't have to input 12 meds, 10 diagnoses, etc.
But billing, that's up to the coders. Nobody will ever tell you E codes, V codes, etc. Just put as many diagnoses as you can think of. Someone well versed in ICD 9/10 will be much better at it than you ever will.
Truthfully, at most places, someone other than you should scribe in PMH, PSH, SH, and FH. At the place I moonlight, the nurses do it. Yeah, I ask it to make sure something isn't missed, but I don't have to input 12 meds, 10 diagnoses, etc.
