The emergency department is the front door to the hospital and for many people, the only source of medical attention that they can turn to. For that reason alone, it is extremely important that the ED is properly reimbursed for the services it provides. Here are some reasons why that reimbursement may not be getting back to your hospital.
1. Lost charts
Each lost chart costs a facility approximately $120 or five clerical hours of labor. These costs really begin to stack up. If you are averaging just three lost charts per day, that’s 1,095 charts lost per year, costing the facility $131,400. Sorini ER Solution’s team of coders manually analyzes every code daily to prevent any charts from being lost.
Backlog is the accumulation of lost charts over an extended period of time. Recuperating these charts expends a lot of time and labor which could be otherwise focused on addressing the regularly incoming charts. Many facilities will carry backlog between 30 and 60 days. Our proprietary precoding methodology will help eliminate your current backlog and prevent the accumulation of any further.
3. Inaccurate coding
Inaccuracies in coding can lead to a variety of problematic situations for EDs. If there is a growing trend in codes being inaccurately assigned to higher levels than what’s appropriate, there is danger of that ED coming under scrutiny for “upcoding” which is illegal. If codes are being assigned to lower levels than what is appropriate, that ED will be missing out on proper reimbursement and may struggle to maintain high quality facilities and staff.
4. Software limitations
Issues related to coding software services may be costing you more than you think. Many software systems will not permit human override for inaccurate coding. Although the software will allow the user to reassign a code to a lower level, there is no way to reassign to a higher level than what is originally coded. Those software systems that utilize the chief complaint method of coding do not yield the most accurate codes to represent the work taking place in the ED. Sorini ER Solutions uses resource utilization based coding standards that are proven to yield the highest accuracy in coding.
5. Lack of focus on outpatient visits
The staggering difference in volume and perceived revenue opportunity between outpatient visits and hospital admissions can be deceiving. Although the estimated payments for patients admitted into the hospital far outweighs that of outpatient ED visits, the higher volume of those patient’s payments can actually add up to a significant sum.
At Sorini ER Solutions, our focus is on making sure that your hospital’s ED attains the reimbursement it deserves. To find out more, visit us at sorinisolutions.com