Three Keys to Successful Physician Charge Capture in an ICD-10 World

Guest post by Donald M. Burt, MD, Chief Medical Officer, PatientKeeper, Inc.

Don Burt
Don Burt

Many physicians and revenue cycle professionals at healthcare provider organizations are suffering acute ICD-10sion as the calendar flips relentlessly toward October 1.

For all the complexity associated with ICD-10, there are some relatively simple things healthcare providers can do to prepare the front-end of their revenue cycle for the change-over. By “front-end” we mean physician charge capture, the origin of much of a practice’s revenue. The key to success is to make physician charge capture as tailored, flexible, and straightforward as possible for physicians, billers and coders.

A system is tailored when it exposes only relevant codes to physicians in a particular specialty or department, and when it provides fine-tuned code edits. It is flexible when it lets physicians enter charges on the device of their choice – a computer in the office or at home, a smartphone in the car, a tablet anywhere – and when it gives physicians the ability to use familiar clinical terminology to look up codes. And a charge capture system is straightforward when it is seamlessly integrated into physicians’ workflow via the EHR, and into the finance staff’s workflow via the billing system, necessitating fewer clicks, taps and swipes by all users.

An organization that knows this firsthand is Stony Brook University Physicians on New York’s Long Island. This academic practice affiliated with Stony Brook University School of Medicine has 17 clinical departments through which patient care services are rendered and billed.

For a variety of business reasons, the group’s administrative arm, called the Clinical Practice Management Plan (CPMP), implemented an electronic charge capture solution 10 years ago. A return-on-investment (ROI) study of several departments showed that, over a six month period, charges increased by $2.5 million ($5 million annualized) and claim volume increased by 29 percent. Overall, these departments saw a 50 percent reduction in lag days. One department with particularly dramatic results saw its number of claims increase by nearly 70 percent, while the number of coding issues actually declined by six percent. Clinicians can now quickly and easily record charges for services they deliver – at the point of care, in the office, or anywhere in between.

Along the way, Stony Brook CPMP gained valuable insight into the critical elements that make up a successful charge capture system.

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