Vinny,
Thanks for paying attention to this topic. Again, what I want and what we all really need, is a way to track and maintain a record of these never establised patients who none the less, want to hold us accountable for their misdeeds. And NOT have them be part of the main database, but separated out as they are, because they are different.
Your office and ours does the same thing, they are not patients and therefore they are not entered into AC until the get their fannies in here for that first establishing visit. But the reason we both do this is because AC doesn't allow us some way of tracking, recording, and yet separating out these very difficult and dangerous patients.
Great example. We have a young peds patient that has yet to establish. What has happened is not the patient's fault here, but that of his mother. She has made and broken FIVE appointments now. Never yet to establish!!! This is bull and we all know it. But I need to protect you, my doctor by documenting all these phonecalls and appointments as to why this patient is no longer welcome at our practice. Especially if such patients are SCHIPS, or other gov't type program enrollees. And guess what this kids dad it turns out works for a major insurance company! Like he isn't gonna try and get pushy with us if we discharge his family for abusing our scheduling and wasting our doctor's time and staff resources, right???
Right now we are documenting all new patients in a separate false patient, "New Patient". But having all that data in one folder just isn't very HIPAA, now is it? No more HIPAA than combining all patients into one chart, right? We need a separate HIPAA compliant chart, for each and everyone of these pains in the butts. To document their mis-deeds for any future "suprises". And off the main database because they are not part of the practice. And trackable unto themselves because this is a real issue we need the data from to fight with carriers and the gov't as to the trouble these types of folks are and what they cost us in money, time and resources. Even broken down by products and the like. If and when they establish, then any and all things that happen at that date should then go live with the AC side of things. Do you get at what I'm getting at here???
Would it really be so difficult to have a dual numbering system??? So at the end of the day we may have let's say 1200 TEMP file numbers and 1000 real AC file numbers. With the main subset intersecting so to speak? Most of these folks will eventually become real established patients. Perhaps Some way of changing status while retaining both. Only those who have established get into the real AC numbering system, and all their temp info and their Temp number gets carried over. So any one patient could be both TEMP123 and AC456. But once AC456 the old TEMP123 data is in let's say past encounters sect or imported items??? But never to reuse the same number on either side. So only Paul B will ever be TEMP123 or AC456. They still may have an issue that first arose as a TEMP even though they are now an AC let's say and we should be able to retain and access all of this stuff.
In a paper chart this is easy. Simply create a new paper chart and use two numbering systems. All while documenting these diffucult patients. Messages saved to the paper chart and all the rest. Once they establish, give 'em their new in sequencial order regular number and away you go. All without ever letting the two co-mingle and having all the stuff from both sides recorded and saved...It may be a pain in the butt from a database, programing standpoint for all I know, but this is the reality of our business and the real flow of our offices, we need to find a way to allow this to happen in just about the fashion I have laid out here. It's for the protection of all the providers who use this program.
Thanks for listening....
Paul
