Industry Insight

AHIMA Foundation Launches New Department of Labor-Recognized Apprenticeship Role: Inpatient Coding Auditor

The AHIMA Foundation is pleased to announce the expansion of its registered apprenticeship program to include an Inpatient Coding Auditor role based on recent employer feedback. Registered apprenticeship, a proven strategy, ensures quality workforce readiness training by combining on-the-job learning with hands-on instruction to prepare exceptional workers for American industry. The process of apprenticeship program registration is designed to ensure that working apprentices, program employers, and the public can gain a clear understanding of the training content and that measures that are in place to ensure ongoing quality.

The increase in regulatory audits, downgrading Medicare Severity Diagnosis Related Groups (MS-DRGs) under ICD-10 and an increase in denials are drivers of impacting the growing need for this role. Inpatient coding auditors bring knowledge of code validation and accurate MS-DRG assignment, classification of coding and denial issues, and the ability to analyze audit results in order to track and trend overall improvement and resolution. Employers can now choose inpatient coding auditor from the six available roles helping to build a stronger and more experienced health information workforce.

“Our new Inpatient Coding Auditor role will help our apprentice increase the revenue and improved data quality of their employers because nothing will be misplaced or delayed,” says Keith D. Terry, CHPC, interim executive director of the AHIMA Foundation.

Now is the time for organizations to join the AHIMA Foundation program to expand apprenticeships in health care and meet their talent needs and to stay competitive. The registered apprenticeship program can be an effective component of an employer’s staffing strategy and a talent development pathway for workers to gain additional skills and credentials. The AHIMA Foundation offers a free webinar for those wanting to learn more.

The AHIMA Foundation is completing year four of the five-year American Apprenticeship Initiative grant from the US Department of Labor (DOL) to support the expansion of registered apprenticeship programs into career pathways to meet employer needs, particularly into new fields such as HIM. The AHIMA Foundation has been working with the DOL Office of Apprenticeship in addition to state apprenticeship agencies to help employers work through the process of creating and sustaining their registered apprenticeship programs.

— Source: AHIMA Foundation

Partnership Hopes to Prevent Patient Identification Errors

QuadraMed, a division of Harris Healthcare, has collaborated with LexisNexis Risk Solutions to improve patient matching for QuadraMed’s Enterprise Master Patient Index (EMPI) software and clean-up customers. Specifically, QuadraMed’s EMPI data cleansing services will use LexisNexis Risk Solutions to expedite the resolution of unmatched patient identity or duplicate records to unique identities. LexisNexis Risk Solutions’ vast referential repository of data sources will be used in conjunction with information uncovered during QuadraMed’s EMPI projects to ensure correct patient record matching.

QuadraMed diagnoses, treats, cures, and prevents patient identity issues through software and services, including duplicate and overlap reconciliation. Its ability to confirm that multiple records represent the same person is dependent on the quality of patient data provided by health care systems which may be outdated or incorrect. LexisNexis Risk Solutions’ sophisticated proprietary linking technology and vast referential data, including records from disparate public and proprietary data sources, matches these records to unique individuals to further expedite and automate QuadraMed’s services.

“QuadraMed is pleased to partner with LexisNexis Risk Solutions to augment data for our EMPI SmartCleanup engagements. Duplicate medical records are an issue within most health care systems today and can lead to fragmented care, patient and physician dissatisfaction, and billing errors,” says Mike Tardif, executive vice president of Harris Healthcare. “By querying LexisNexis Risk Solutions for the most current demographic data when the data available to us is insufficient, we expect to greatly increase our ability to match and merge records during our cleanup engagements. This, in turn, enables us to leave our customers with better data and has a positive impact on patient care, patient and physician satisfaction, and revenue for the organization.”

“Our alliance with QuadraMed is a great example of industry experts combining different capabilities to tackle data fragmentation and help health care facilities offer safer and more efficient care,” says Josh Schoeller, senior vice president and general manager of LexisNexis risk solutions, health care. “Correct, complete records are fundamental for proper patient diagnosis and treatment as well as hospital reimbursement, as inaccurate patient identification can result in denied claims.”

— Source: QuadraMed