Subjective coding practices, human error, end-of-shift tick sheets and notes attached to scrubs…it’s no wonder that most EDs are a drag on their hospital’s bottom line. ED revenue cycle management and documentation that accurately reflects the patient encounter has never been more critical. With increasing operating costs, growing complexities of the ED and booming patient volumes, hospitals can’t afford to have their EDs hemorrhage money. 

 

EDs need a revenue cycle management makeover to become profit centers. Automated processes, more complete and thorough documentation, and a consistently applied charge capture and coding methodology are essential to improve the financial health of today’s EDs. In light of CMS’ new regulations with RAC Audits to ensure proper payments, it’s even more important to eradicate error-prone manual coding and apply automated processes to mitigate compliance risk and support your charge capture methodology.

 

The most logical solution is transitioning away from paper documentation methods and implementing software systems. Unfortunately many of these ED systems emulate paper offerings or supply endless features that don’t solve the fundamental financial problems plaguing our EDs. 

 

It’s important that your EDIS solve the most acute issue – incomplete documentation and charting deficiencies. The EDIS must make it easy to track every element of care from a patient’s initial contact through disposition. Your EDIS should utilize a facility coding logic that follows CMS principles and consistently and accurately captures the hospital resources and interventions provided. The AMA just published the 2009 CPT codes, and while the good news is that not much has changed, it is essential that your EDIS have the flexibility to incorporate new codes and other regulatory changes as they are issued…especially since CMS no longer allows a grace period for implementation of code sets.

 

Facilities that have deployed ED systems with easy to use and robust clinical documentation quickly discover that their charts often support higher levels of service than previously documented. By eliminating variations in the information charted, EDs can eliminate down coding and improve patient acuity profiles. And removing bookkeeping functions from the endless list of nurse responsibilities means they have more time to concentrate on patient care.

 

Your EDIS should deliver other positive results including:

·         Process and workflow enhancements that make your ED more efficient while reducing diversions and  boosting patient throughput.

·         Better patient experiences that enhance your ED’s reputation, making it the community’s choice provider of emergency care.

·         Legible and thorough charts that reduce down coding and errors and automated charge capture processes that eliminate coder bias.

·         A streamlined charge capture process which allows for point of service billing and shortens the traditional billing turnaround time so you can meet insurance company requirements and receive reimbursement faster.

 

By employing an EDIS that improves processes and aligns clinical documentation and charge capture, you can quickly reap patient care and workflow benefits while contributing to the financial health of your hospital.

 

Patricia Daiker, RN, BC