Documentation in a managed care organization is considerably different from a ge

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Documentation in a managed care organization is considerably different from a general healthcare organization. The responsibilities to the patients also differ and physicians in managed care owe responsibility to third party, the MCO. Patients in managed care are seen under different circumstances, probably by different level of provider but still under the guidance of the physician. Hence, documentation in managed care organization needs to more specific and better organized. In MCO, documentation goes far beyond medical records, and every interchange between the organization and the patient is recorded. It also includes information and advertisements about the organization/practice, distributed by the MCO, the records specifying the representation made to patients by the physician, and the records of communication between the patient and the physician.

Tailored, pre-printed forms are used for informed consent of the patient, pre- and post-op instructions, preventive care services, and rehabilitation. Hence, computer documentation is a common practice in MCOs, due to the efficiency, accuracy and legibility advantages they offer. Apart from that, the documentation confidentiality is also a major focus, as all the observations, given care and interventions and the patients’ responses are recorded.

Managed care organizations are reimbursed by the insurance providers and government programs only for properly documented patient care. The nursing notes are thoroughly reviewed by them; hence proper documentation is very important in managed care organizations. In managed care documentation is thus used both for quality control and as a justification for reimbursement from Medicaid, Medicare or private insurance providers.

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what are the documentation practices within managed care organization

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