Wednesday, September 30, 2015

Journey to 10

Destination: ICD-10
Total Miles: unknown
Total Cost: TBD

Well, it's almost upon us!

Doomsday: October 1st, 2015.

Tomorrow is the day...will the world of healthcare come to complete stop? Will healthcare insurance come grinding to a halt in payments? Will. We. Survive?! (no. no. and yes.)


Back up.

What is ICD-10, you are asking? And why are you on a "journey" to it?

ICD-10 is a code classification system that allows the healthcare provider to use a specific diagnosis code to communicate what is wrong with you when you go for a visit. The current system is ICD-9 and about 20-30 years out-of-date. The rest of the world uses ICD-10 (if they use a system), and they have for years.

Perspective: If you had gone today to see a healthcare provider to be diagnosed with ebola, there is not a code in ICD-9 to diagnose you with it. And there is no way to create a code in ICD-9 to let your insurance company know what you were seen and treated for at that visit.

So, our practice (and every practice in America) is updating to the new system tomorrow. On a patient level, it really should not affect your visits. It will mean, if used correctly, that your diagnoses will be more specific (so that when you bring your child back for a f/u for that ear infection, the provider will now be able to look at the previous diagnosis code and know if it was right/left/bilateral without having to question you or dig through the notes).

On a practice level, it's a lot of prep. Which I won't go into because it would not make much sense...suffice to say that for about 6 1/2 months, my team and I have been going to meetings, watching webinars, attending classes, batching test claims, and converting hundreds of templates to the new codes to make sure the whole place transitions smoothly.

What does this have to do with road trips and journeys you may ask?

Well, my iPhone defines journey as "A long and often difficult process of personal change and development." And this process has seen a lot of personal growth. I've learned things about healthcare that will better help me serve my patients. I've learned a small portion of how much goes into the billing department which will better help me understand the hard work and effort it takes to communicate effectively with insurances companies.

And I've learned a lot about myself:

I am not much for desk childhood issues involving attention deficits and procrastination have been major hurdles over which I have labored to jump.

I have commitment issues when it comes to labeling specific templates...rumor has it that "unspecified" codes (codes that are not as specific in labeling) will not be paid out...and there are A LOT of unspecified codes.

I do not know my alphabet as well as I should at my age. The ICD-10-CM draft is divided into two sections, both of which are alphabetized (think massive index that is over 1100 pages long). I have found myself singing the alphabet song more than any adult my age should just to remember where K comes in the alphabet. #facepalm

I am borderline OCD about labeling and really have to work against trying to control every little thing about the templates.

I do not know nearly enough medical knowledge. Which is humbling.

I am in love with my practice. With the support they give me every day. With the countless little moments each provider has taken to answer my (very) random questions about various topics and diseases. With the staff members who have encouraged me to persevere. With the management who have tirelessly worked with the team to transition smoothly and accurately. With my fellow ICD-10 team members who have sacrificed more than any one will know to make this thing work.

And work it shall.

At the beginning of the project during one of our meetings, I was reminded of a quote that I read when I worked night shift at the applies so well to life, to road trips, to the journey of countless miles:

And make the turn, we shall! 

Monday, September 28, 2015

Labor Day Road Trips

Destination: Fort Wayne, Indiana
Total Miles: 1,500 (roughly)
Total Cost: Somewhere around $150

What better activity to do for Labor Day weekend than to go visit out-of-state family?! Having a slightly longer weekend and the option of leaving a little early on Friday presented me with the perfect road trip opportunity: visit Will and Kara in Fort Wayne (while the weather is still decent enough for this Southern girl).

I will admit that the weekend came up faster than I had thought it would, so Thursday night and Friday morning found me scrambling to pack and prepare before work Friday morning.

The previous two weeks had been spent in ICD-10 preparation (more to come on that journey!), and I was anxious to get out of the office and away from the computer to hit the roads for a few hours.

Will (my "little" 6'5'' brother) and his wife, Kara, moved to Fort Wayne around Memorial Day. Her family is from there, and the timing worked out for them to move (much to the Guidinger Clan's dismay since it's the farthest move of any of the siblings to date). It is about 9 1/2 to 10 hours from Greenville...and conveniently takes one within 6 minutes of Grandma's house in Knoxville!

First stop of the trip after driving through the beloved and much traveled I-40 mountain stretch was at Grandma's exit for some Starbucks and a quick visit with Grandma and Pap. After a refreshing drink and visit, I was back on the road with an audiobook to entertain and about 5 days worth of music to pick and choose from for listening.

Saturday morning found me waking up at my usual 7 a.m. Kara had to work the morning, so Will took me out for a bicycle ride around a path they like to was great to catch up, and we even managed to get caught in a torrential downpour (no thanks to the weather channel app that did not show a chance of rain that morning!). To dry off and warm up post-ride, we headed to one of Will and Kara's favorite little coffee shops for more catching-up and cappucinos.

The rest of the day was spent hanging out with Will, Kara, and a couple of her brothers. We stuffed ourselves and had some good laughs at a Brazilian restaurant, went to the Dollar theatre to see Inside Out (yes, I was one of the best Pixar movies...and I've seen almost all of them), and managed to squeeze in a couple games of UNO in the evening while snacking on our favorite: Oreos and milk.

The weekend was definitely a weekend of firsts for me! Two of the biggest were on my bucket list of "Things To Do Before I Turn Thirty." Namely: Laser Tag and learning to drive stick-shift. Both of which I thoroughly enjoyed! We played two rounds of Laser Tag, and Will taught me on Sunday after lunch how to drive manual transmission...which was a lot of fun in spite of my initial difficulty pulling forward after stops.

Sunday was a busy and fun day: we visited a church near their apartment for the morning service, ate a delicious breakfast and lunch prepared by my amazing sister-in-law, drove around learning stick-shift, went to DeBrand's for some amazing iced hot chocolate and a chocolate Sundae, and a side road trip to Ohio for the afternoon/evening (which bears some explanation--see the post-script).

On Labor Day, we all slept in until 9 a.m. and lounged about, playing UNO until Kara won a hand. I decided since I don't get DeBrand's a whole lot, that we should go back for a brunch...which then turned into a stop at Panda Express for lunch. Definitely a huge fan of their Orange Chicken. :)

After lunch, it was time to hit the road home, and after the goodbyes, I headed South a little happier for having spent time with people I love.

Last stop of the trip before home was, of course, supper at Grandma's! She had specially made tacos (my favorite!), and it was so fun to visit for a few minutes before taking on that I-40 mountain stretch.

More trips to blog about...stay tuned!

PS: explain the Ohio trip, three words: Chocolate. Zucchini. Bread.

I am friends with a lot of people, and one of the things I love about being friends with others is having the opportunity to meet their friends and family. In my Sunday School class at church, there are two brothers who are from Ohio. Over the past few months, I've gotten to know both of them a little better. At the beginning of the summer when my zucchini plants were producing their bumper crop, one of the brothers shared their mom's recipe for chocolate zucchini bread with me. It's amazing. With that, came her phone number in case I had questions about the recipe or whatnot. We've stayed in touch throughout the summer, and on the Friday morning that I was leaving for Fort Wayne, I decided to look at a map to get the basics on where I was heading. A town in Ohio caught my eye, and I remembered one of the brothers saying they were from Spencerville. Sure enough, it was only an hour and a half from Fort Wayne. I decided to see if it would work out for me to meet and give my personal thanks to the mom for sharing the recipe. Not only did it work out, but I was able to go to church in the evening with the oldest brother and then go to a graduation party and play a couple hours of volleyball with some of the church people. The brothers' family was so gracious, and I thoroughly enjoyed my side-trip to Ohio and am thankful for new friends!

Tuesday, July 7, 2015

Five days and almost 2,400 miles later...

Destination: Niagara Falls (and Boston)
Total Miles: 2,391 (driving total)
Total Cost: $350 a piece

For a while now, my friend, Chenille, and I have been talking about going to Niagara Falls. It's been on my bucket list for a very, very long time. Back in March, we decided to opt to take a couple extra days off around July 4th and roadtrip somewhere.

Enter Niagara Falls.

What could be more patriotic than Niagara Falls? Actually, Chenille suggested that Boston and the Fireworks Spectacular show they hold annually could be more patriotic. And since I know people, it was then decided that we could drive up to Niagara then drive over to Boston.

In order to understand a little better how this all came about, there is something you should know about Chenille and I: we share a love for randomness (as long as it includes some quality time and Starbucks).

With a basic plan in place to leave after we got off work on Thursday, stop somewhere along the way to Niagara Falls to spend the night, then stay at the Falls in a quaint B&B (on the Canadian side because everyone says it's better), then drive across New England to Boston, see the fireworks and spend the night with my friend, and then head home, we looked forward to our northern trip.

To begin with, we started out a little later than planned due to some last minute work issues. Once we got on the road, we realized it would be better to follow directions not on our phone maps which would eat up data, so we took pictures of the directions. Which turned into a hilarious adventure since there were several places that the road signs were not clear.

A little random tidbit of deja vu: once we hit onto 77 in NC, I realized that it was the exact same road I had taken Sunday to get to Winston-Salem for a day trip.

As we traveled, we got to talking so much that before we knew it, it was pushing 1 a.m., and we were in the middle of No-Where, West Virginia. We finally found a somewhat decent looking motel at a decent price near Clarksville (I think), and by 2 a.m. we were checked in and reassuring ourselves that the closest Starbucks was only 20 minutes away.

Back on the road again, we headed northward.

Remember the whole "follow the picture of the directions" thing? Yeah. We ended up crossing the border into Canada much sooner than we planned. At which point, Chenille was reading off directions to our B&B when our phones dinged with warnings that we were on foreign soil and would be charged roaming fees.


We quickly switched over to Airplane Mode. Only to realize we had no clue where we were or where we were going.

Much laughter ensued, and thanks to our awesome navigation skills, we managed to find our B&B which was 30 minutes away, in sufficient time.

Then to get back across to the American side so we could ride the famous Maid of the Mist, we walked 1.2 miles, crossing the border on foot (another adventure!). And after a 2 hour long wait in line, we boarded the Maid of the Mist dressed in the blue rain ponchos that were given us (I actually wore my yellow raincoat over top of mine which was a fun contrast to the 599 other people on board).

Surreal. Phenomenal. Breath-taking.

Words truly cannot capture the magnificent power of the Falls.

That evening, we had the pleasure of watching some beautiful fireworks over the Falls (and meeting a couple from Winnipeg, and realizing that people from the Orient have NO concept of personal space!).

The next morning, we were served breakfast right to our room and enjoyed lounging about for a few minutes pretending we were rich socialites.

After breakfast, we hit the road, crossed the border, and commenced the reading of our study book: The 5 Love Languages for Singles. It took us 3 days to make it through the entire book, but it was well worth the hours of reading aloud and discussions that ensued. No, I will not go into all our discussions, but suffice it to say that it was thought-provoking and that I look forward to the application of the principles learned as I seek to love those around me. :) dear friend from nursing school, Katie, opened her home to me yet again. Her husband was awesome enough to map out an entire plan for getting all of us down to Cambridge for the fireworks show. The show was even more fantastic and spectacular than I or Chenille had even imagined. But, I think my favorite part was just the adventure of hanging out with old and new friends. I will say, if you opt to go see the fireworks, make sure you are standing across from the barge that they are shot off of, and also make sure you stick around for a little bit after the show is done because then you can stand by the railing and get cool pictures of the Boston harbour with fireworks that are shot after the crowd leaves because they did not fire off correctly during the show.

The next morning after a delicious breakfast (Katie is one of the most amazing cooks!), Chenille and I headed toward Maryland. Except that we got turned around and found ourselves on northbound lanes out of Boston. To which we turned in to an excursion to find a Starbucks with a drive-thru.

Southbound again, we managed to make our way out of the city without using the GPS. At some point, I offered that we could take a detour to see one of my aunts' farm and get some ice cream for lunch. Another adventure ensued and after traversing the lovely countryside of Connecticut, we finally found our way back to the main road and opted to make our next stop Philadelphia.

Somewhere along the way, we managed to navigate ourselves straight into the middle of the Bronx, and I have now crossed "Driving (and staying alive to tell) through the Bronx" off my bucket list only after having to put it on there involuntarily. Got some lovely views of NYC and also some great laughs and memories with Chenille.

Once in Philly, we enjoyed making some stops to see the Liberty Bell and Independence Hall before heading down to Geno's Steaks for a taste of delicious and atherosclerosis-inducing world famous Philly Cheesesteaks.

Last stop on Sunday was at another aunt's house, where I am fondly known as "Dora the Explorer." We spent the night up the street at a church member's house, and before we knew it, it was Monday morning. Aunt Cindy prepared a delicious breakfast (can't compete with biscuits and gravy!) for us to partake of prior to heading home.

As we left, we decided since we were apparently on a somewhat "Patriotic City" tour, it would only be fitting to stop in Washington DC and check out some memorials (and Starbucks) before heading the rest of the way home. Except that, per my normal DC-traffic-issues, it took forever to find parking. The day was warm, but the sites were, as always, worth the walk.

The road home was littered with traffic, cops, and not enough coffee places. But home we arrived in one piece, about 2 hours later than planned, but in one piece and with hundreds of pictures and even more memories made of our adventures.

So, here's to adventures both planned and unplanned, the randomness of crazy music (Crayola doesn't make a color for your eyes?), the spontaneity of no GPS, and the fun and memorable bonding moments with a great friend.  May the road rise up to meet you.

Greenville, SC