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HIM Shifts Ahead: 3 Trends for Revenue Cycle to Know

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The shift in roles, responsibilities and reporting structures for Health Information Management (HIM) professionals is top of mind for healthcare revenue cycle and finance executives as we enter 2015.

What lies ahead for HIM and their relationship to revenue cycle? Here are three trends for healthcare finance executives to consider.

1. Shift Coding to Revenue Cycle / Finance

Coding requires close monitoring, oversight and hand-in-hand communication with billing, accounts receivables and audit management. Coding also impacts quality reporting, and accurate code assignment is essential for correct revenue recognition under value-based reimbursement. A future shift of coding ownership to revenue cycle makes sense for most organizations.

How should CFOs and revenue cycle directors prepare? –> Strong channels of communication among clinical documentation, coding professionals and accounts receivable teams must be in place to efficiently process the influx of claims denials expected with ICD-10. Tighten your coding and revenue cycle relationship now to help brace your organization for the massive earthquake to come.

2. Shift HIM Leadership toward Information Governance

Information governance (IG) is an essential requirement for an electronic world. In healthcare, IG is generally defined as the “need to control electronic patient information.” It requires the “adoption and ingraining of principles, a framework, rules and managed processes” according to AHIMA. During their recent convention, AHIMA released the industry’s first guiding principles for information governance in healthcare—the central theme of the conference.

Why should healthcare executives care about IG? –> In paper environments, your HIM department is both clean-up crew and traffic cop. They are the final check to ensure patient information is clean, correct and complete.  HIM also directs the flow of patient information within and outside of organizations.

These same tasks must be covered in an electronic world. They are even more essential as multiple EHRs, overlapping systems and a plethora of information networks come together through mergers, acquisitions and health information exchange.

3. Shift HIM Operations to IT

From small hospitals to large, multi-location delivery systems, HIM Directors report a seismic shift: operational functions are moving under IT while coding responsibilities are being managed by revenue cycle executives.

What does this mean for hospital executives? –> Operational budgets, management reporting structures, and staffing allocations for all HIM functions should be revisited. Look for future HIM responsibilities to be covered “without walls” as technology enables centralization, virtualization and greater HIM outsourcing. Functions likely to shift include such tasks as release of information, document scanning, information/data analysis, and master patient index management.

Is Your HIM Department Shifting?

Many hospital HIM departments are shifting toward information governance and split departmental responsibilities. One of our clients in Boston is moving ahead as well. More details about Massachusetts Eye and Ear Hospital’s HIM shift in my next blog.

What HIM changes are taking place at your facility? And how are they impacting your revenue cycle?

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