Utilization Management and Clinical Documentation for Pediatric Hospitalists
Summary
Accurate clinical documentation has never been more crucial. Pediatric Hospitalists face a full spectrum of medical conditions in their careers. Regardless of a provider’s level of experience, the addition of new standards and policies, in both number and complexity, necessitate continued education.
Utilization Management and Clinical Documentation for Pediatric Hospitalists is an educational program on clinical documentation. It is broken into two modules. The first is a didactic covering the fundamental principles of both utilization management and clinical documentation. The second is a module of multiple case studies that walks participants through common diagnoses in Hospital Medicine to illustrate clinical documentation and status determinations using the standard of medical necessity.
Goal
Pediatric Hospitalists will be able to produce more accurate and comprehensive clinical documentation, which will help ensure quality patient care and proper reimbursement for the level of care provided.
Target Audience
This series is for any pediatric hospitalist who manages patients in the hospital setting.
Learning Objectives
By the end of this series, participants will be better prepared to:
- Decide how to include more specificity and less ambiguity in clinical documentation.
- Recognize different financial models and DRGs/Bundled Payments and how accurate diagnosis capture optimizes reimbursement.
- Apply knowledge about status definitions to select the appropriate status level for the patient and understanding this diagnostic selection impacts hospital, patient, physician, insurance company, and researchers.
Release Date: July 25, 2022 Expiration Date: July 25, 2025
Group Orders
If you are you interested in purchasing access for two or more providers, contact us at education@hospitalmedicine.org for a special group rate.
Utilization Management and Clinical Documentation for Pediatric Hospitalists consists of two modules:
Module 1: The Basics
- Part I: Foundations of Hospital Finance and Clinical Documentation
- Part II: Hospital Status Determination: Making the Right Decision for You Patient
- Module Quiz
Module 2: Case Studies
- Session 1: Common Pediatric Diagnosis
- Session 2: Complex Pediatric Diagnosis
- Module Quiz
Content recorded and current as of June and July 2022.
Instructions
The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. Both modules consists of a study program and CME evaluation. All sections must be completed to receive CME credit and MOC points.
Disclaimer
The contents included in this presentation are for informational purposes only. The coding and documentation guidance provided herein does not replace the Official Coding Guidelines or professional judgment and expertise of the individual performing coding and documentation based on numerous factors including, but not limited to, documentation in the medical record, correct application of coding guidelines, and other industry recognized coding guidance. Coding guidelines and references are updated on an annual basis potentially impacting the accuracy of the content contained within this presentation. Reference official coding resources for up-to-date information. Neither SHM nor the speakers guarantee that the information supplied is without defect. Reasonable effort has been made to ensure accuracy, completeness, and relevance and to ensure that the educational information provided in this presentation is accurate and useful.
Disclosure
The faculty and planners of these activities have no relevant relationships to disclose unless denoted below. All relevant relationships were mitigated prior to the start of this activity.
Acknowledgements
Wendy Arafiles, MD
Phoenix Children’s Hospital
Daxa Clarke, MD
Phoenix Children's Hospital
Amy Sanderson, MD
Boston Children’s Hospital
Utilization Management and Clinical Documentation for Pediatric Hospitalists: The Case Studies
Wendy Arafiles, MD
Phoenix Children’s Hospital
Lucinda Lo, MD
Children's Hospital pf Philadelphia
Sheilah Snyder, MD
Children’s Hospital of Omaha
Accreditation Statement
The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Statement
The Society of Hospital Medicine designates this enduring activity for a maximum of 3.00 AMA PRA Category 1 CreditTM. Physicians should claim only credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 3.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.
Price
If you are you interested in purchasing access for two or more providers, contact us at education@hospitalmedicine.org for a special group rate.