PCRs and new(?) medicare rules [Archive] - Glock Talk

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D25
10-06-2008, 16:39
So I just got done with a meeting with our billing person so that we can relearn how to write PCRs. Apparently we need to dumb it down a little- no technical words, no abbreviations. This pill is being forced down our gullets because, according to our office, these changes are being dictated by Medicare, but I wonder....

Anything similar happening with you folks?

(I'm going to loose it the first time I have to write out HEENT.)

1bamashooter
10-06-2008, 22:30
So I just got done with a meeting with our billing person so that we can relearn how to write PCRs. Apparently we need to dumb it down a little- no technical words, no abbreviations. This pill is being forced down our gullets because, according to our office, these changes are being dictated by Medicare, but I wonder....

Anything similar happening with you folks?

(I'm going to loose it the first time I have to write out HEENT.)

Been doing it for years now, some of it is Medicare some of it is your billing dept not understanding what you document. We use E-PCR so I don't have that problem any more.


I hated that they made no abbreviations but did not give any more room to write on a PCR.

AmbulanceMonkee
10-07-2008, 14:23
Non-standard abbreviations here are discouraged, but still acceptable. We're transitioning to Zoll's ePCR software in the next month, so we'll see how that works.

DaleGribble
10-08-2008, 17:48
So I just got done with a meeting with our billing person so that we can relearn how to write PCRs. Apparently we need to dumb it down a little- no technical words, no abbreviations. This pill is being forced down our gullets because, according to our office, these changes are being dictated by Medicare, but I wonder....

Anything similar happening with you folks?

(I'm going to loose it the first time I have to write out HEENT.)

I work for three different 911 agencies and one private service and I haven't heard anything like that from any of them. Someone at your job is being a dumb ass.

Is Medicare going to tell the entire medical profession to dumb it down and tell doctors to start writing legibly from now on as well?

1bamashooter
10-08-2008, 21:59
Non-standard abbreviations here are discouraged, but still acceptable. We're transitioning to Zoll's ePCR software in the next month, so we'll see how that works.

You will HATE the ePCR at first then you get used to it then some prick IT dude puts more on there to fill out and doesn't tell you how or what to do and you cannot finish your report until somebody explains it to you. I have thrown my toughbook across the room 3-4 times because of ePCR so get ready to throw ****.

AmbulanceMonkee
10-08-2008, 22:20
Good thing we have toughbooks and they're supposed to be impossible to destroy. Sounds like I'm damn sure going to try.

4095fanatic
10-09-2008, 07:15
Way I'm used to: A.O.S. t/f 81 y/o F with c/c of CP.

Way we're supposed to: Arrived on scene to find an 81 year old female with a chief complain of chest pain.

My compromise: A.O.S. t/f 81 y/o F with a c/c of chest pain :).

If they gave me an extra page to write my narrative on I'd have no problem spelling it all out, but when the page isn't really that big forget it. Still waiting for us to go to electronic forms you print out at the hospital...

D25
10-09-2008, 21:39
I just don't think that my MEDICAL charting should be changed by someone in billing, or IT.:steamed:

As a side note, starting out a report with "Nine- one- one dispatch to..." is a good way to be labeled a smart ass, and the billing department can't come up with a way to not use abbreviations for STEMI.:whistling:

Lynn D
10-11-2008, 18:55
Haven't had any sort of update about medicare rules. Hope not, either, since a majority of folks I transport are over 65. I do know about some of the new hospital rules (no payment for hospital acquired UTIs or bed sores, etc.).

We also do e-PCR (emsCharts)....I'd rather do paper. I'm a nurse and use a lot of abbreviations. Fortunately, our QA folks haven't seemed to have a problem with it.

If someone wants to tell me how many throws to destroy a toughbook, I'll gladly try it! :)

ks_emt
10-12-2008, 09:24
At my service we use emscharts. i like it that you can get a report done fairly quickly, but there is a lot to be desired on the system. Not every pt. falls into a picklist or pop up box. although i do prefer it to writing them out by hand.

aspartz
10-12-2008, 15:40
Minnesota had MNStar. It is the epitome of dumbing down. Almost everything is a checkbox now. Too bad none of the boxes apply to most runs.

Our now departed manager seemed to think we all worked for billing. We were even told to ignore how the Pt was found. It seems (or she thought) that if you put "Pt found seated on...." medicare would refuse payment because if the pt could sit in a chair, they could sit in a car. Nevermind that 10/10 chest pain. :upeyes:

She had a coniption when I started w/ "Pt found standing outside ER smoking cigarette" and continued w/ "Pt refuses any contact and will not allow vitals to be assessed." You gotta love the PITA dumping transfers.

ARS

ks_emt
10-13-2008, 10:26
We have heard some rumors that Medicare is going to start paying on what dispatch puts the call out as. Yes we have good dispatchers that are EMD certified, but there is a lot of times that we are dispatched for a sick person and it ends up being a code blue.

D25
10-13-2008, 11:52
We have heard some rumors that Medicare is going to start paying on what dispatch puts the call out as. Yes we have good dispatchers that are EMD certified, but there is a lot of times that we are dispatched for a sick person and it ends up being a code blue.

That is true. It used to be that an ALS Medicare reimbursement hinged on an IV and an EKG, now it has to do with dispatch info. The financially conservative part of me appreciates this, but the realistic part of me knows it's going to cause problems for 2 reasons. First, we all know that we get dispatched to benign stuff that evolves into really bad juju. Second, this system implies a tiered response system where BLS rigs are available to go to BLS calls, and they can request paramedic intercepts if circumstances dictate. Well, that might work in some places, but there are strictly ALS rigs here, and in many, many other places that don't have huge populations. I don't think that replacing half of the paramedics with basics (no insult intended) would be good for this industry, or good for prehospital healthcare in general. It's another example of some accountant dictating patient care.

Tvov
10-13-2008, 15:45
We have heard some rumors that Medicare is going to start paying on what dispatch puts the call out as. Yes we have good dispatchers that are EMD certified, but there is a lot of times that we are dispatched for a sick person and it ends up being a code blue.

How the heck would they bill for "unknown medical, person on the ground"??

ks_emt
10-13-2008, 18:09
How the heck would they bill for "unknown medical, person on the ground"??

exactly my thoughts.

M249SAW
10-16-2008, 16:38
We have the Panasonic Toughbooks with the Zoll ePCR system. Not a big fan, but I write sloppy so I guess its better than the old carbon copies

AmbulanceMonkee
10-16-2008, 17:13
We have the Panasonic Toughbooks with the Zoll ePCR system. Not a big fan, but I write sloppy so I guess its better than the old carbon copies

Same setup we're going with here in upstate NY. Spent two hours in class yesterday learning about all the "benefits" of giving up my LP12 for the POS Zoll E series. I give those things 90 days before our crews destroy them. Do you drive a "Slime Green Taxi" down there in Florida, too??

M249SAW
10-16-2008, 22:17
Nope I work in Pasco, we stick the the conventional red/white.

Sucks you are going to the Zoll from the LP12s. We have the Zolls with bluetooth for syncing our EKG strips to the tablet, but no auto BP cuffs. LP are a much better unit IMO.

The toughbooks are actually pretty tough, the weak spot on ours is the huge Verizon air card sticking out of the side. I think we replaced 20-30 of the aircards the first year we had them, lol.

RLDS45S
10-17-2008, 21:33
One has to remember that KISS applies to other other areas.....hence there is NO universal medical abbreviation database, oh wait unless the GOVT approved it. Long story short....you gotta realize that medicare processors might be half a country a way.

Medicare is a larger payor ergo the way they go so other insurance payors.....

1bamashooter
10-18-2008, 18:31
Nope I work in Pasco, we stick the the conventional red/white.

Sucks you are going to the Zoll from the LP12s. We have the Zolls with bluetooth for syncing our EKG strips to the tablet, but no auto BP cuffs. LP are a much better unit IMO.

The toughbooks are actually pretty tough, the weak spot on ours is the huge Verizon air card sticking out of the side. I think we replaced 20-30 of the aircards the first year we had them, lol.

We use the Air Link on our TB with ePCR its slow as hell but it works and will not break.