Q&A: Sharing denials data with the medical staff

Q: What is a good strategy for sharing denials data with the medical staff to ensure they understand weaknesses?

A: Hospitals have been in the habit of sharing data with their medical staff for a long time. Over the years, reports have become more sophisticated. It has never been more important to share data with the medical staff in regard to their track records with documenting the appropriate information for medical necessity, continued stay, DRGs, and the substantiation of docu­mented diagnoses. Physicians must be our allies in these challenging times and sharing their own data with them is a good first step. If they don’t understand the problems, how can they correct them?

The best way to provide information to the medical staff is face to face, either at a department meeting or in their offices. Start on a positive note with data that demonstrate successes. Data that indicate a need for improved documentation can be used as an educational tool. Denial team members themselves can educate the medical staff, but it will also take support from senior leadership and medical staff leaders to emphasize the need for compliance by all physicians. Your physician advisor can be very helpful here.

Editor’s note: This article was originally published in Revenue Cycle Advisor. For more information, see The Contemporary Guide to Health Information Management.