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Editor's e-Note
As if patient matching wasn’t already enough of a concern, a new element has entered the fray: self-scheduling. Born out of the telehealth surge, this development has providers scratching their heads on how to best get a handle on it.

Like most everything these days, the situation is being exacerbated by the pandemic. This month’s E-News Exclusive attempts to make sense of it all while chronicling the experiences of providers across the nation.

Lee DeOrio, editor
e-News Exclusive
Self-Scheduling and COVID-19: Necessity Adds to Health Care’s Patient Matching Woes
By Karen Proffitt, MHIIM, RHIA, CHP

The explosive popularity of telehealth to ensure ongoing access to care as COVID-19 ravages the nation brings with it an equally rapid rise in patient self-scheduling—an upward trajectory accelerated by the need for streamlined methods of scheduling vaccinations.

Born of necessity, self-scheduling has nonetheless added to the already dismal state of patient matching. Desperate for appointments, many patients inadvertently create multiple medical record numbers as they work through the schedule system, wreaking havoc on health care organizations’ electronic master patient index (EMPI) and EHR systems, as well as the ongoing quest for a 1% or lower duplication rate.

An excellent example of the self-scheduling boom can be found in the massive popularity of a patient portal-based COVID-19 self-triage and self-scheduling tool created in February 2020 by University of California, San Francisco (UCSF) Health for use by primary care patients at UCSF Health. In a study published in the Journal of the American Medical Informatics Association, UCSF Health researchers reported that, during the first 16 days of use, the tool was accessed 1,327 times and completed 1,129 times by 950 unique patients. Furthermore, 29 patients—56% of patients placed in the nonurgent disposition category following self-triage—directly scheduled video visits in the 10 days during which video visit direct scheduling was active. And they did so far faster than patients who called the system’s hotline to schedule visits.

Full story »
Products & Services
Fellow Health Partners Launches Suite of ‘Powerful Tools’
Fellow Health Partners, a New York–based medical business solutions company, has launched its new, updated website which features a bundle of four integrated solutions, Powerful Tools, that help physician practices, medical facilities, and hospitals improve their billing experience. The company’s four proprietary tools work together to drive satisfaction and client revenue. Its SimpleSwitch process makes it smoother, more reliable, and less stressful to switch billing companies. SimpleSwitch couples with its TruTest process which anticipates the “hot spots” in billing and smooths them out before they can become a problem, reducing errors and improving accuracy. The third tool used by Fellow Health Partners is their one-of-a-kind Knowledge College, a unique in-house training facility located at their New York headquarters. It solves for the fact that many billing problems are simply the result of undertraining in technical and people skills. These three tools are supported by the backbone of Fellow Health Partners, its proprietary technological innovation called SAVi. Built by its extensive in-house tech team, this total workflow solution drives efficiency for its team and clients, while operating as a 24/7 transparent tool that allows providers and facilities access to all their billing information at the touch of a button. It also provides business analytics while remaining EHR platform agnostic. Fellow Health Partners is excited to premiere these tools together on its new website because all four tools have turned out to be especially valuable during the pandemic. They can be applied remotely without having to put clients or staff at risk, and the Knowledge College training is just as effective for clients and staff when conducted online. Learn more »

Genesis RCM Announces New RCM Division
Genesis RCM (Genesis) introduces its new hospital-based revenue cycle division, enabling small and mid-sized hospitals and health care systems to fully benefit from its broad swath of expertise in medical billing and collections, receivables improvement, denial management, prior authorization processing, and more. Genesis has been providing these services for close to a decade to ambulatory practices of all sizes, enterprise-sized health system-owned physician networks, and different departments within hospital frameworks, and saw the demand to build a team of equally experienced and dedicated inpatient specialists that would allow it to close the loop on offering truly complete revenue cycle solutions across the health care continuum to its clients. The organization’s move to formalize its new hospital division is driven in large part by customer feedback looking for additional support in the inpatient segment and a recognition that both practices and hospitals are increasingly seeking to streamline their vendor relationships. Genesis will go to market immediately with its inpatient service offerings and will focus its efforts in the small to medium-size hospital space, including both independent facilities and those that operate within the scope of a larger health system. Learn more »

DrChrono EHR Now Supports Health Records on iPhone
DrChrono’s open FHIR API is now live, enabling its patient members to securely transfer their available health records out of DrChrono into the Apple Health app on iPhone. Health Records brings together hospitals, clinics, and the existing Apple Health app to make it easy for patients to see their available medical data from multiple providers whenever they choose. The Health Records feature is part of the Health app, which also shows activity, heart rate, nutrition, and other health data consolidated from iPhone, Apple Watch, and HealthKit-enabled third-party apps. Previously, patients’ medical records were held in multiple locations, requiring patients to log into each care provider’s website to piece together the information manually; Health Records creates a direct connection between medical institutions and a patient’s iPhone, allowing them to see a central view of their allergies, conditions, immunizations, lab results, medications, procedures, and vitals. It also notifies patients when their data are updated. Health Records on iPhone was designed to protect patients’ privacy through utilizing a direct, encrypted connection between the user’s iPhone and participating health care organizations. Users authenticate through their patient portal credentials. Downloaded health records data are stored on-device and encrypted with the user’s iPhone passcode, Touch ID, or Face ID. Patients whose providers are participating in Health Records on iPhone are now able to easily consolidate all of their available medical records data into the Apple Health app by going into the Health app on their iPhone, navigating to Health Records, selecting their provider, and logging in with their OnPatient credentials. Learn more »
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Industry Insight
Report Details How Telehealth Can Advance Women’s Health Care Access and Equity

The National Partnership for Women & Families released a report on telehealth and women’s health care access in advance of the US House Energy and Commerce Subcommittee on Health’s recent hearing on the future of telehealth.

The coronavirus pandemic has dramatically accelerated the use of telehealth. As we emerge from the pandemic—which has exacerbated health care inequities and disproportionately harmed Black, Indigenous, and other people of color—we must use this opportunity to build systems that meet those communities‘ needs. The National Partnership for Women & Families is committed to developing and deploying telehealth models that improve health outcomes and equity. The value and limitations of telehealth for women and families of diverse backgrounds must be clearly understood to ensure that telehealth delivers on its promise.

Providers are currently using telehealth to address crucial aspects of women’s health care: contraception, abortion care, maternal health, and mental health.

Expanding telehealth could also facilitate women’s roles as the primary caregivers and health care managers for their family members.

The report, “Delivering on the Promise of Telehealth: How to Advance Health Care Access and Equity for Women,” explores the challenges that structural inequality poses to telehealth and best practices to address them.

— Source: The National Partnership for Women & Families

Read more »
Ask the Expert
Have a coding or documentation question? Get an expert answer by sending an email to

This month’s selection:
High flow nasal cannula is a common treatment for COVID patients. There are three different codes based on time of continuous use. Do you use the flow sheets? Progress notes by providers? Or combination?

Kathleen M. Craig, RHIA, CCS

Personally, I’d use whatever notes I could find; ventilator flow sheets are typically more specific than hoping a provider/physician will document times at all, much less accurately. Respiratory therapist notes are reliable sources as well.

— Judy Sturgeon, CCS, CCDS, CICA, is the clinical coding/reimbursement compliance manager at Harris County Hospital District in Houston and a contributing editor at For The Record.
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