Medical/dental staff newsbriefs [January 1997]

              3&
Wesley Long
COMMUNITY HOSPITAL,
MEDICAL/DENTAL STAFF
JANUARY 1997
Medical/Dental Staff Officers
David H. Newman, M.D.
President
Medical/Dental Staff
S. Dean MoPnail, M.D.
President/Heot
Medical/Dental Staff
Robert J. Evans, M.D.
Chief, Dept. of Surgery
David D. Grove, M.D.
Chief, Dept. of Medicine
Kenneth H. Winter, M.D.
Chief, Dept. of Radiology
R. Preston Lentz, M.D.
Chief, Dept. of Pediatrics
S. Dean McPhail, M.D.
Chief, Dept. of OB/GYN
Executive Staff
Gary L. Park
President/CEO
Timothy J. Clontz
Executive Vice-President
tewart, VP,
lenn A. Visbeen, VP
P. Winchester, VP
Medical/Dental Staff
Newsbrief is published by
he Medical Staff Services
Department.
FROM THE DESK OF DR. JOHN PATRICK,
PATHOLOGIST. . .
New ThinPrep Pap Test Replaces 50-Year Old
Method
Annually, more than 100 million pap tests are
performed worldwide and, according to the National
Institutes of Health, between two and three million
of these yield abnormal results. In some cases as
many as 80% of cells are discarded with the current
collection device and up to 40% of all pap smears are
unreliable due to the presence of blood, mucus and
inflammation.
Fortunately, a major advance in pap test technology
has been approved by the Food and Drug
Administration. The ThinPrep 2000 System is the
first new pap test procedure in 50 years. This new
test allows the cell sample to be collected in the
traditional manner, therefore patients will not be
impacted; however ThinPrep simplifies the collection
of pap smears, enhances cell yield, and also
decreases the number of repeat smears.
The most significant advances with ThinPrep are seen
within the medical laboratory. The new test has
significantly reduced the risk that the sample may
contain blood or infection. Additionally, it will now
be possible to do multiple tests from the same
sampling and women can be assured of a more
reliable analysis.
FROM MEDICAL RECORDS. . .
DID YOU KNOW that when coding orthopedic
conditions (i.e. rotator cuff tear), it is necessary to
document whether the condition is acute or chronic.
If the condition is acute, documentation should
include how and where the injury occurred.
FROM MEDICAL STAFF SERVICES. . .
If you anticipate the addition of a partner(s) to
your practice in 1997, please contact the Medical
Staff Services Department at the following
numbers: 854-6226 or 854-6291. Once an
application is received by Medical Staff Services,
the verification process takes approximately 4-6
weeks. A timely return of the application to us
will assist in "smooth sailing" for all.
FROM CASE MANAGEMENT. . .
Payor Requests for Medical Information
The Case Management Staff is receiving over 500
calls a month from insurance companies and
review agencies requesting medical information
on inpatients regarding symptoms, diagnostic
tests, treatments, plan of care, estimated discharge
date, and any discharge planning needs.
The Milliman and Robertson Criteria is used most
frequently, and is agressive; however, we find a
great variation in the reviewers. Some are quite
reasonable, while others will approve one day at
a time and have unrealistic expectations regarding
discharge readiness and continued care needs.
The Case Management Staff will provide
information on inpatients, as requested, and will
refer calls to the attending whenever there is not
enough information available in the patient's
medical record to support the need for acute care,
or whenever the reviewer is making unrealistic
requests. We will work with the Medical Staff to
appeal any denial of inpatient care whenever
possible. Patients may be held liable for charges
incurred for any denied days, so we need to work
together and make every effort to get all inpatient
care approved and avoid denials.