This past spring, Memorial Medical Center ED Manager Teresa Miller discovered a $50,000 revenue increase in just three months by optimizing the organization’s billing processes.
Memorial Medical Center ED in Port Lavaca, Texas, which treats around 10,100 patients annually, contracted T-System to use their RevCycle+ consulting services to conduct a thorough review of documentation from physicians to evaluate the quality of their documentation. T-System is an emergency department documentation solutions company based in Dallas.
According to Miller, physician education was deemed necessary after inconsistencies were discovered. The vendor also reviewed the coding staff's work and determined that there was a pre-training code variance rate of 43 percent on the physician side, attributing to the confusion of medical decision-making complexity for provider coding.
In addition, the company also completed a chargemaster gap analysis at Memorial Medical Center ED and made recommendations based on the findings.
“There’s a lot to correct coding and our coder had not had appropriate training. She learned a lot that she hadn’t known she was doing incorrectly,” said Miller. “Sometimes the codes were not being correctly fixed once identified as incorrect. There were several things not being charged that could be charged for. A few small things all made a huge difference.”
According to Miller, once the organization’s coding process was analyzed and physicians and coders were properly trained, the ED saw a $50,000 increase in revenue between February and May 2012.
Miller said many nurses and physicians were not always correctly indicating start and stop times for IV use or were leaving out important coding information due to incorrect training or simply forgetting. With the new coding training and system, Miller said the program utilizes “hard stops” so that important information is not left out of any report.
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“Inside the system all the information is there to click on. Before this, you could close the system without all the information needed. We have a hard stop system so that the coder has to enter all the correct information before closing out. Staring at charts all day long, it’s easy to miss a piece of information,” she said. “Memorial Medical Center is no longer losing revenue on hydrations and infusions. The changes we made as a result of this have had a huge and almost immediate impact to our bottom line."