Best Practice Panel Sharing the Learning and Growing Stronger Together!

Patty Richert RN, Huron Family Practice Center, CIPA WHAT: Advance Care Planning (S0257) HOW: –Discussed with every patient 18 and over –Focus on type of care, Durable Medical Power of Attorney, patient confidence level –Help patients to talk through decisions HINTS FOR OTHERS: –Rehearse the discussion before beginning with patients –Discuss importance for parents or grandparents

Patty Richert RN, Huron Family Practice Center, CIPA WHAT: G and CPT Code Volumes HOW: –Focus on chronic care patients –Leverage the physician’s schedule –Aim to deliver at the time of patient service –Incorporates support group meetings HINTS FOR OTHERS: –Look at physician’s schedule in advance to identify eligible and appropriate patients –Use the registry as a tool –Daily basis persistence, build rapport with patients

Mary Ellen Cross, Dr Peddireddy’s Practice, CIPA WHAT: BCBSM Eligibility Near the Point of Service HOW: – The Care Manager checks the schedule and identifies members who would benefit from care management and gives them to the office manager. – The Office Manager checks Web DENNIS for the PDCM benefit and apprises the Care Manager – Patients with HDHPs are not offered care management HINTS FOR OTHERS: – Work as a team – let the clinicians focus on the clinical and the operational experts focus on eligibility, etc. – Adopt a process. Start with something. Improve over time. – Checking the day before is practical, doesn't slow the patient intake process down, and helps the practice to prepare for the next day's care schedule

Mary Ellen Cross, Dr Peddireddy’s Practice, CIPA, cont. WebDennis and the Benefit Explainer

Laurie Oakes, Taylor Clinic, Oakwood ACO WHAT: Transition of Care Codes (99495, 99496) HOW: – The practice uses Crimson Care Mgt for tracking of care management codes, as well as ADT alerting – When ADT alerts are received, the CM contacts the patient to get them scheduled for an office visit and books the visit in NextGen (the EMR) as a TCM – Both the physician and CM work together when the patient is seen. – The CM does an initial medication reconciliation – The care plan is reviewed and updated and the patient is assessed for additional needs with a focus on patient understanding – The initial contact and the office visit are documented in the EMR (NextGen) and the billing is started in the EMR – When the patient leaves, the claim is pended for 30 days and submitted if the patient is not rehospitalized. HINTS FOR OTHERS: – Having a standard process allows the holding of the bill for 30 days to be practical – Someone must have responsibility to check for a subsequent admission

Deb Moody, Grand Haven and Holland South, Spectrum WHAT: Physician Engagement G9007 HOW: – Practices schedule and block time for team conferences (e.g. biweekly) and adjust according to patient need – Part of system-wide move to an advanced practice model HINTS FOR OTHERS: – Start with physicians who are engaged – Helps when the practice has a large panel size – Start small and grow the number of scheduled conferences, but start somewhere (even if monthly)

Nan Hibler, RN, Dr. Lambrix, IHP WHAT: Medicare Annual Wellness Visit G0438 and G0439 HOW: – The practice instituted a process to always ensure that the patient has a next visit scheduled (if not a follow-up, then their annual wellness visit) for Medicare and all other patients. T – The G0439 and G0438 codes on the drop down selector for physicians to choose from when they characterize a visit. – This drop down triggers the rest of the documentation system to initiate the bill and claim HINTS FOR OTHER PRACTICES – With the ACA, an annual wellness visit is a universal benefit – The same characteristics (the use of a standard process, the inclusion of the code on the drop down, etc.) can be used to improve any G or CPT code process in a practice

Time Allowing…… Do you have a best practice for improvement on a key process step or code tied to billing and coding? Come up to the table, make yourself a table tent and share with your peers!