What is " chart review?"

Katnip, RN · Sep 14, 2008

I think they mean something like utilization review. At my place, it's not nurses who are hired to do that because nurses are more expensive than the social workers they usually hire.

And even the places that do hire nurses usually require some bedside experience because you really need to understand what's going on.

Bluehair · Sep 14, 2008

I think they mean something like utilization review. At my place, it's not nurses who are hired to do that because nurses are more expensive than the social workers they usually hire.
And even the places that do hire nurses usually require some bedside experience because you really need to understand what's going on.

Any Utilization Review staff I have ever seen have been RN's, often BSN preferred in most job listings. I thought most social workers were masters level education, and would cost more? And yes, any UR positions I have seen posted generally require some amount of experience in patient care for the reason you cited.

ana tomy · Sep 14, 2008

Who would go through Nursing school and want to do just "chart review"..That scares me..Why would you go through Nursing at all!

vlntrnurs · Sep 14, 2008

Chart reviews by RNs may refer to auditing and/or utilization review (UR).

There are certifications in RN-auditor or RN-coder. More information can be found at:

http://www.rn-coder.com/index.html

http://www.rn-coder.com/certification/reasonstobecomecertified.html

There used to be the CPUR (Certified Professional in Utilization Review) and the CPUM (Certified Professional in Utilization Management) offered by McKesson.

Both the CPUR and CPUM have been combined, and now the certification is the CPHM (Certified Professional in Healthcare Management). You can find more information at McKesson's website:

http://www.mckesson.com/en_us/McKesson.com/For%2BPayors/Private%2BSector/Professional%2BCertification/Professional%2BCertification.html

In addition to the CPHM and RN-auditor, other certifications are as follows:

CHC (Certified in Healthcare Compliance) offered through the Health Care Compliance Association. More information can be found at:

http://www.hcca-info.org/AM/Template.cfm?Section=CHC_Certification

CPHQ (Certified Professional in Healthcare Quality) offered through the Healthcare Quality Certification Board. More information can be found at:

http://www.cphq.org/

There is the CCM (Certified Case Manager). More information can be found at:

http://www.ccmcertification.org/

There are also the certifications offered through the American Nurses Credentialing Center (ANCC), such as the Case Management Nurse and the Informatics Nurse. For these 2 certifications, you will need work experience in the specialties to take the exam.

http://www.nursecredentialing.org/certification.aspx

Check out the requirements to take all the certification exams. Some may not require work experience, which would allow new graduates or RNs (in diverse fields) to take the exam and move into fields dealing with chart review.

Rhone · Sep 14, 2008

I thought most social workers were masters level education, and would cost more?

Pay is horrible for social workers and other mental health professionals. Average pay for MSWs is over $10k less than floor RNs according to salary.com (and they generally have to do lengthy unpaid internships before they can get licensed).

My wife has a Masters in Psych, plus post-graduate stuff to get licensed as a therapist, and makes around 36k/year. At my last job--a direct care job where my BA in Psych was a requirement--I started at less than 24k/year and ended up with a little over 30k after earning my way up to a senior position. That was at a job where horrible staff ratios (sound familiar?) along with the natural stress of the field generally burns people out and drives them away within a year or two.

I'll be making more than my wife (who has had about 6 years of schooling, plus hundreds of hours of an unpaid externship) around this time next year when I'm done with the LPN program I just started.

pagandeva2000, LPN · Sep 14, 2008

It amazes me how other professions have to invest so much time and money to obtain their Bachelor's and Master's Degrees to make less money. In fact, it is downright scary.

Mbalcitacmas · Nov 29, 2009

chart review is a board term. in addition to the description noted in previous blogs, this could also include chart review to validate reimbursement and coding issues looking for appropriateness of bills or claims filed with medicare/medicaid, workmens comp, or private/commercial insurance plans. there are many factors that trigger chart review.. under and over charges, suspected fraud and abuse, determining prospective payment schemes for the government, looking for patterns of coding groupings for drg or opps, and other settings such as physician practice, dme, home health etc.

to learn more about medical audit, visit aamas -

american association of medical audit specialists

for quality issues --- these could be preparing for accreditation such as jcaho, ncqa, urac or hedis review. this is how nursing can be exciting as it leads to tons of opportunities in addition to the typical bedside clinical nursing.

chart review is also involved with research or determining patient safety concerns with clinical trials, emerging technology or new products involved in clinical care.

elkpark · Nov 29, 2009

Check out the requirements to take all the certification exams. Some may not require work experience, which would allow new graduates or RNs (in diverse fields) to take the exam and move into fields dealing with chart review.

IMHO, that is a v. scary thought ...