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

 

There are two versions of the Grouper screen, the Medical Records Grouper and the Insurance Grouper, below is an explanation of each.

 

•Medical Records Grouper: Displays the coding information entered by Medical Records. Information entered here will automatically copy to the Insurance Grouper.

 

•Insurance Grouper: Displays the diagnosis and procedure information entered by Medical Records. The 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 security, the Grouper screens may be view only, or maintenance may be allowed through this option. Listed below are the combinations of behavior controls that may be used to assign access to the Grouper. The path to access these behavior controls is: Special Functions > Identity Management > Logins > select a Login > Behavior Controls.

 

•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, the login must also be given access to the Applications listed below. The path to access the Application rules for a login is: Special Functions > Identity Management > 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 will automatically be set to allow for users in the Health Information Management role as a system default.

 

NOTE: Access to the Table Maintenance application will only need to be granted if the user needs the ability to edit the Medical Records or Insurance Grouper.