Since electronic medical records (EMR) have become prevalent, there has been concern whether documentation in the patient record accurately reflects medical necessity and the services provided. When I started working in the healthcare setting, we always told providers, “Not documented, not done.” Now, when I review a chart note, the question I have to ask myself is, “There is documentation, but was it done, today?” With the ability to import previously gathered information into the current note with just a few clicks, it’s possible that the information wasn’t reviewed at that specific encounter.
Medical Billing Blog
Following widespread discontent with the meaningful use program and EHR policies, the American Medical Association (AMA) has released a list of eight priorities to improve quality and usability during EHR adoption.
More hospitals are planning to outsource coding efforts in the coming year, according to a new survey published by Black Book Rankings.