The Health Information Management (HIM) unit requests to add three (3) PFT Medical Record Technicians (MRTs) to decrease the overtime pay that has been ongoing within the unit due to the increased volume of work the unit has received. To meet the demands, the HIM unit must hire additional MRTs and assign one (1) MRT to the following locations: Martinez Health Center (Org # 6516), West County Health Center (Org # 6515), and Concord Health Center (Org # 6512). MRTs perform and are cross-trained in all aspects of HIM operations where they must maintain compliance with the release of information, conduct patient identity activities, and fulfill legal requirements. According to the website of the Medical Board of California, the Medical Board may take any action against the physician and/or business for failing to provide the records within the legal time limit. In order for the County to not be fined per violation, incumbents are working overtime to process patient requests. Adding the additional positions will provide more structure, save the County money by decreasing overtime pay, and will not risk getting fined by the State.
In addition, the Patient Billing unit requests to add one (1) PFT Medical Records Coder (Org # 6569) which will be a part of the California Advancing and Innovating Medi-Cal (CalAIM) initiative as the Department of Health Care Services (DHCS) aims to reform Behavior Health documentation requirements. To achieve this, DHCS will streamline and standardize clinical documentation requirements across Medi-Cal Specialty Mental Health Services (SMHS), Drug Medi-Cal (DMC), and Drug Medi-Cal Organized Delivery System (DMC-ODS) services. These new requirements will better align with the Centers for Medicare and Medicaid Services’ national coding standards and physical health care documentation practices. Effective July 1, 2023, the chart documentation requirement for SMHS, DMC, and DMC-ODS will be enforced. DHCS will monitor plans and counties for compliance with documentation standards and deviations from the standards will require corrective action plans. To ensure the County follows the state mandate, the Medical Records Coder will review all changes, review all code accounts, and make corrections to ensure the correct Current Procedural Terminology (CPT) code is being applied prior to billing claims being submitted for services provided.
If this action is not approved, overtime pay in the Health Information Management (HIM) unit will not be addressed and the County will be fined by the State per violation if the County does not provide information exchange for clinical, legal, financial/billing purposes, and personal needs within the legal time limit. Also, the Patient Billing unit will not have appropriate staff to ensure compliance with mandated documentation requirements leaving the County at risk of audit and/or a corrective action plan from the Department of Health Care Services (DHCS) and reduced revenue for services provided.