“We have one final surprise tonight – and it’s something we’ve all been able to keep a secret,” laughed Angie Christen. She was holding a large, white album with a ribbon tied around it.
“Betsy, can you please come up here?”
It was the final night of Health Information Associates 25th Anniversary celebration and, to mark the momentous occasion, founder and CEO Betsy Bailey invited all HIA employees and their guest to the Salamander Resort in Middleburg, Virginia. The three-day event was exactly what she had hoped for, a nonstop celebration with everyone that helped the company reach this milestone.
“We wanted to give you something to show how much we appreciate you, this company, and all it has brought to our lives,” continued Christen as Bailey made her way to the stage.
The past three days had been a truly humbling experience for Bailey – she never imagined her one-woman coding consulting company , which she started in a home office in North Carolina, would turn into one of the most respected in the industry, creating more than 250 jobs in its 25 years.
But the celebration was also bittersweet as there was one very important member of the HIA family missing – her dad, Deane Beamer, with whom she founded the company with in 1992. Beamer passed away in 2012 at the age of 78.
Once Christen gave the album to Bailey and she realized its contents, she was speechless. In the album were handwritten letters from every HIA employee. Many of them had been with the company for more than a decade. Each letter told a different story of how they came on board with the company and what the HIA family meant to them.
It was a pinch-me-moment for Bailey.
“I still don’t know how this all happened,” she laughed.
Growing up, Bailey and her dad had a special bond – especially when it came to business.
“I loved it. Especially those dinner table conversations, talking about the healthcare industry and bouncing ideas off of each other,” she said. “It’s just how I grew up.”
Beamer, a veteran of the United States Air Force, studied at the Medical College of Virginia where he received his Master’s Degree in Hospital Administration. He completed his residency at Memorial Mission Hospital in Asheville, North Carolina and then moved to Marion, Virginia to serve as CEO where he was instrumental in establishing Smyth County Community Hospital. After retiring from SCCH, Beamer consulted and served in various interim hospital CEO positions throughout the Southeast.
Bailey attended Emory & Henry College for three years, before transferring with her now husband Bruce to the Medical College of Virginia where she received her BS in Health Information Management. Following graduation she took a job as the Director of Medical Records at Tidewater Memorial Hospital from 1987-1988 (now Riverside Tappahannock) and then moved on in 1988 to the Director of HIM at Humana St. Lukes Hospital in Richmond, Va. (now Parham Doctors Hospital )
Bailey’s husband, having completed his Masters in Health Administration, was offered a job as Assistant CEO at Humana Clinch Valley in Richlands, Virginia in 1990 (now Clinch Valley Medical Center) It was following their relocation to Richlands that Bailey entered the healthcare auditing world as a self-employed consultant. Her first client in 1990 was her Dad’s hospital. Once Beamer saw his daughter’s findings and the educational opportunities for his coding staff, he spread the word to other area hospitals that this is something they really should be doing. Bailey added several more hospitals to her small business.
“I honestly wanted to help these not-for-profit hospitals get the reimbursement they deserved because the smaller facilities were struggling in those days. In addition, I loved teaching what I knew about coding to their staff.”
It was also during this period that Bailey had her first child, Beth Ann, in 1991.
As Bruce’s career progressed, the couple moved to North Carolina to pursue an opportunity at Lake Norman Regional Medical Center in Mooresville.
“Supporting Bruce’s career and being a mom were important to me,” she said. “But I also wanted to continue to grow my own business and keep my coding skills sharp. I guess you could say I wanted to have it all.”
It was in 1992 that Bailey landed her largest client to date – a group of HCA hospitals based out of Richmond, VA. At the same time she found out she was pregnant with her second child, Tyler.
“I remember thinking ‘there’s no way I can handle this all on my own and do these contracts justice,’” said Bailey. “That’s when my dad advised me that it may be time to hire someone to help me.”
That same year, Bailey with the support of her dad founded Health Information Associates, Inc. They hired their first employee, Pam Riddle, that same year. In the year to follow she hired her next two employees Amanda Williams (now Roeschke) and Patti Kulp, both who were former classmates at Medical College of Virginia with her…and are still with the company to this day.
“And I guess that’s when it all started,” laughed Bailey.
In the first five years, Bailey also hired Christen, now VP of Operations at HIA and Joel Shealy, now VP of Business Development.
“I swear, even in the early years, I just thought ‘this is so much fun, I get to work with my best friends every day and do something I love.’”
“It still hadn’t hit me.”
As the coding review relationships continued to grow, more and more clients began looking for other ways to take advantage of HIA’s expertise. Soon the requests for as needed coding support to cover vacations, maternity leaves and vacancies began rolling in and another mainstay service line was born. Interim Coding Management was not far behind and eventually services were expanded to encompass the physician coding and compliance side.
Bailey says the gradual growth of HIA over the next several years – during which she also welcomed her third child, Rachel – was by design.
“We grew slowly but steadily. We didn’t want to take big risks and I never wanted to hire someone if I couldn’t guarantee consistent work for them,” she said. “Clients were patient with us because they knew the quality of work we produced – so they would wait until we could fulfill the contract.”
Bailey says Christen and Shealy were instrumental to HIA’s growth.
“Every corner we turned another opportunity presented itself and we would say ‘okay what do we need to do to get to this level?’ – but we never made huge leaps or ventured outside of our area of expertise, coding,” said Bailey. “We made every decision as a team.”
By 1999, HIA had clients in 26 states. It was that same year that Bailey took over the company as sole owner, with Beamer continuing to serve as an advisor.
By 2011, the company had more than doubled in size.
Today, HIA has clients spanning 45 states and continues to employ only the best in the industry.
“For me, these aren’t just employees – they are family,” said Bailey.
The sentiment rings true to all that HIA does – from its slogan The People Behind the Numbers to its annual meeting, instead called the Family Reunion.
“Even as we continue to hire on more people, we still maintain the core values we established so many years ago,” said Bailey. “HIA is only as good as its people – and I truly believe we have the best of the best in this industry.”
Bailey often refers to HIA as another child of hers, and she believes the culture she has established for the company is not something to take for granted.
Case and point: she wants her kids to work elsewhere for at least two years until they even consider joining the company.
“I don’t believe in just giving your children a handout because you have a successful business,” she said. “Of course, you always want them to be interested in what you are doing, but it’s up to them to figure that part out. I would love to have them all working for HIA someday but this may not be the path for all of them – they have their own interests and I support that.
That sentiment made this year’s celebration that much more special for Bailey, whose daughter Beth Ann Moran, 26, joined the company as part of the recruitment team nearly two years ago.
“To see her have the same love and respect for this company and its people that I do – it makes me unbelievably proud,” said Bailey.
Moran says joining the HIA family “officially” is a dream come true.
“I grew up with most of you and I feel so lucky to be a part of this amazing company,” said Moran during the event Salamander. “I saw how hard my mom worked and how much she and my ‘Big Daddy’ cared for all of you, so it really is special for me.”
For Bailey, it’s a full circle moment.
“Now it’s Beth Ann and me, in addition to my husband, sitting at the dinner table, talking business and bouncing ideas off of each other,” she said.
Bailey paused for a moment as she looked at the album of letters before continuing.
“I can’t thank you all enough for taking a leap of faith and joining me on this journey,” said Bailey. “Working with you all day in and day out has been the greatest joy of my life.”
She could only think of one other person who would be more overjoyed than her in that moment.
“I have no doubt that my dad is up there, celebrating harder, screaming louder, than any of us right now,” she said. “He is so proud of all we have done.”
In the weeks following the celebration, Bailey says she reads the letters often daily.
“They are constant reminders of how lucky I am to be in this position and they serve as motivation on those days when you are feeling down or stressed,” she said.
As for what is next for HIA, Bailey says she will do what she’s always done, work with her team to ensure they are on the right track.
“The industry is changing so much and, we have to change with it. Or change before it,” she said. “We need to be prepared for what’s coming – and we will be.”
Bailey says the company will navigate the changes the same way they always have – as a team.
“I think we are successful because the people working here have a say – their voices matter,” she said. “And that’s something – no matter how much we grow – that’s something we’ll never change.”
Why are so many AKI records being denied? It’s hard to give one answer for why so many AKI records are being denied lately, but most appear to be due to the multiple sets of criteria available for use in determining if a patient has AKI, as well as physician documentation. As stated in Part 3 of this series, there are three main criteria/classifications used to diagnose AKI.
In previous parts of this series we looked at the definitions of AKI/ARF, causes, coding and sequencing, and the common clinical indicators that patients present with that are diagnosed with this condition. In Part 4, we will look at the documentation that should be present to report the diagnosis without fear of denial, as well as when a query is needed to clarify the diagnosis.
If the facility does a COVID-19 test, and test is negative, do I need a diagnosis code. The answer is yes, you will report a Z-code. The Z-code depends on the record documentation and circumstances of testing. For any patient receiving a COVID-19 test, if negative, there MUST e a Z-code to describe why the test was taken. (Test negative for COVID-19 and MD does not override negative results).
In the first parts of this series we looked at definitions of AKI/ARF, causes, coding and sequencing. In Part 3, we will look at what clinical indicators would possibly be present to support the diagnosis of AKI/ARF.
The FY2021 IPPS Proposed Rule is out and here are some highlights from it regarding ICD-10 Code proposals. We will know if these changes are permanent after the public comment period is over on July 10, 2020 and CMS prepares the Final Rule, usually out by August 1.
As discussed in Part 1 of this series, AKI/ARF is a common diagnosis that coders see daily. In Part 2, we are going to focus on the different types/specificity of AKI/ARF. We’ll learn what they mean, as well as how to code the diagnosis.
This is part 1 in a series focused on coding of acute kidney injury (AKI) and/or acute renal failure (ARF). AKI/ARF is reported often, but is also one of the most common diagnosis found in denials.
With the proliferation of COVID-19 cases, we thought we would put together a quick reference listing of some of the common scenarios that coders have asked about. As with all coding, coders should follow Official Guidelines for Coding and Reporting and the COVD-19 Frequently Asked Questions document by the AHA.
Effective March 1, Medicare will pay physicians for telehealth services at the same rate as in-person visits for all diagnoses, not just services related to COVID-19. This great for providers whose patients are reluctant to visit the office.
The biggest reasons why some hospital systems are moving to single path coding is to eliminate duplicative processes and to optimize productivity. In addition, costs are reduced when only one coder “touches” the record and completes both types of coding.
Effective with 4/1/2020 discharges, ICD-10-CM code U07.0 is used to report vaping -related disorders. ICD-10-CM code U07.0 (vaping related disorder) should be used when documentation supports that the patient has a lung-related disorder from vaping. This code is found in the new ICD-10-CM Chapter 22. U07.0 will be in listed in the ICD-10-CM manual under a new section: Provisional assignment of new disease of uncertain etiology or emergency use.
The US government and public-health officials are urging consumers to utilize telemedicine for remote treatment, fill prescriptions and get medical attention during the new coronavirus pandemic. The goal is to keep people with symptoms at home and to practice social distancing if their condition doesn’t warrant more intensive hospital care.
Coronavirus: Tips for working from home. Companies around the world have told their employees to stay home and work remotely. Whether you’re a new to this concept or a work from home veteran, here’s some tips to staying productive from our #HIAfamily.
This is the final part of a three part series in which we address how coders can better interact with Clinical Documentation Improvement (CDI) professionals. In this part, we provide an actual example of an effective communication response to CDI.
This is part two of a three part series in which we address how coders can better interact with Clinical Documentation Improvement (CDI) professionals. In this part, we discuss mismatches and how to best go about resolving them. In part three we will provide a case example of best practice interaction.
This is part one of a three part series in which we address how coders can better interact with Clinical Documentation Improvement (CDI) professionals. Many times these departments are separate and the remote environment makes it difficult to interact efficiently between the two departments. In part one, we will discuss the history and objectives of CDI so the coder has a better understanding of CDI’s role.
One reason that coders should report chronic conditions (including history and status codes) on outpatient records is the HCC’s—Hierarchical Condition Categories. The quick and easy explanation of what HCC’s are is each HCC is mapped to certain ICD-10-CM codes or code ranges. HCC coding is designed to estimate future health care costs for patients.
For Part 5 of this 5-part series, we will look at Chapter 4 within ICD-10-CM—E00-E89—Endocrine, Nutritional, and Metabolic Diseases. There is no possible way to include every guideline or coding reference for this chapter, but here are some of the most common issues.
For Part 4 of this 5-part series, we will look at Chapter 10 within ICD-10-CM—J00-J99—Diseases of the Respiratory System. There is no possible way to include every guideline or coding reference for this chapter, but here are some of the most common issues.
For Part 3 of this 5 part series, we will look at Chapter 9 within ICD-10-CM—I00-I99—Diseases of the Circulatory System. This chapter contains so many of the everyday diagnoses that we code such as hypertension, heart disease and stroke.
For Part 2 of this 5-part series, we will look at Chapter 1 within ICD-10-CM—A00-B99—Certain Infectious and Parasitic Diseases. There is no possible way to include every guideline or coding reference for this chapter, but here are some of the most common issues.
For Part 1 of this 5-part series, we will look at Chapter 21 within ICD-10-CM—Z00-Z99—Factors influencing health status and contact with health services. There is no possible way to include every guideline or coding reference for this chapter, but I’ll do my best to touch on some off the most common issues.
The HIM world has been buzzing recently with discussion of “Social Determinants of Health” and coded data. What does this mean for coders and the HIM field?
The Centers for Disease Control and Prevention (CDC) is in process of developing a new code for the COVID-19 (coronavirus) that will be released October 1, 2020. In the meantime, the CDC has provided advice on coding the COVID-19 coronavirus.
We’re finally at the #1 most common DRG with recommendations by HIA for 2019. Just to recap, HIA reviewed over 50,000 inpatient records in 2019. Most have probably already guessed what the correct DRG would be with the most recommendations. There are just some diagnoses and DRG’s that will always be a thorn in the side for coders. #1 DRG with the most recommendations during HIA reviews : DRG 871—Septicemia or severe sepsis w/o mechanical ventilation >96 hours with MCC
We’re now at the second most common DRG with recommendations by HIA for 2019. Just to recap, HIA reviewed over 50,000 inpatient records in 2019. We are counting down to # 1. #2 DRG with the most recommendations during HIA reviews: DRG 872—Septicemia or severe sepsis w/o mechanical ventilation >96 hours w/o MCC.
In 2019, HIA reviewed over 50,000 inpatient records. Wow! That is a lot of records. Even with this large number of records, the DRG’s with recommendations are still the ones that coders typically see during audits. #3 DRG 190—Chronic obstructive pulmonary disease with MCC.
In 2019, HIA reviewed over 50,000 inpatient records. Wow! That is a lot of records. Even with this large number of records, the DRG’s with recommendations are still the ones that coders typically see during audits. #4 is DRG 193—Simple pneumonia & pleurisy with MCC.
In 2019, HIA reviewed over 50,000 inpatient records. Wow! That is a lot of records. Even with this large number of records, the DRG’s with recommendations are still the ones that coders typically see during audits. #5 DRG with the most recommendations during HIA reviews : DRG 853—Infectious & Parasitic diseases with O.R. procedure with MCC