The Grouper is be used to code patient accounts within TruBridge EHR. It allows all diagnosis, procedure, and DRG reimbursement information to be entered and stored directly on the patient account.

 

There are two versions of the Grouper screen:

 

Medical Records Grouper

•Displays the coding information entered by the Medical Records.

•Information entered here will automatically copy to the Insurance Grouper.

 

Insurance Grouper

•Displays the diagnosis and procedure information originally entered by Medical Records.

•Information displayed here may be edited to change the diagnosis and procedure information that displays on the insurance claim.

•Changes made on the Insurance Grouper will not copy back to the Medical Records Grouper.

 

Depending on the user's assigned security, the Grouper screens may be view-only or allow maintenance access.  The path to access Behavior Control rules for a login is: Web Client > System Administration > Logins > select a Login > Behavior Controls.

 

Listed below are the combinations of behavior controls that may be used to assign access to the Grouper.

 

•Coders that require view only access to the Medical Records Grouper should be given the following behavior controls.

▪Code by HIM set to Allow

▪No rule for Edit HIM Diagnosis and Procedure Information -or- Edit HIM Diagnosis and Procedure Information set to Deny*

 

•Coders that require access to view and edit the Medical Records Grouper should be given the following behavior controls:

▪Code by HIM set to Allow

▪Edit HIM Diagnosis and Procedure Information set to Allow*

 

•Coders that require access to view and edit the Medical Records Grouper AND access to view the Insurance Grouper should be given the following behavior controls:

▪Code by HIM set to Allow

▪Edit HIM Diagnosis and Procedure Information set to Allow*

▪Code by Insurance set to Allow

 

•Coders that require access to view and edit BOTH the Medical Records Grouper AND the Insurance Grouper should be given the following behavior controls:

▪Code by HIM set to Allow

▪Code by Insurance set to Allow

▪Edit HIM Diagnosis and Procedure Information set to Allow*

▪Edit Non-HIM Diagnosis and Procedure Information set to Allow

 

•If the user's login is not assigned to the Health Information Management role, additional Applications access must be assigned. The path to access the Application rules for a login is: Web Client > Application Drawer > System Administration > Logins > select a Login > Applications.

▪Coding set to Allow

▪Health Information Management set to Allow

▪Table Maintenance set to Allow**

 

NOTE: The coding behavior control for Edit HIM Diagnosis and Procedure Codes is automatically set to Allow for users in the Health Information Management role by default.

 

NOTE: Access to the Table Maintenance application is only necessary if the user needs the ability to edit the Medical Records or Insurance Grouper.