Tuesday, August 19, 2008

Healthcare Provider Simplifies Billing With Coding Interface

For any business, receiving payments earlier rather than later makes a difference in the bottom line. For healthcare facilities relying on a myriad of insurance companies and government programs for reimbursement for patient treatment, a solution that streamlines the billing system can quickly pay for itself.
A 350-bed private, not-for-profit healthcare service provider in Massachusetts was experiencing delays in getting billing information to the parties responsible for reimbursing the hospital. The hospital uses advanced technological tools, including EMRs (electronic medical records), CPOE (computerized physician order entry), PCS (patient care system/nursing documentation), and BMV (bedside medication verification).
The vast amount of information that passes through the hospital's facilities, including the records of every patient (physician observations, prescription history, diagnoses, procedures performed, tracking of reactions to medications, etc.), must be converted into a universally recognized set of classifications, or codes. Medical coding has become the primary means by which insurance companies determine whom to reimburse for medical procedures and in what amounts.

The provider's healthcare information system relies on a combination of MEDITECH healthcare information system, which manages patient information and medical records; 3M medical encoding software; ProMed Scanning from BizTech Healthcare Solutions to scan medical records; and Valco Data Systems to archive the medical records on the back end.
Until recently, the hospital's medical encoding personnel would have to access patient record information in each of these systems individually in order to gain the patient data necessary to code and abstract a single patient's record.
The hospital's emergency department coding process was even more complicated because the hospital's HIM (health information management) staff was responsible for entering most of the charges generated there. Plus, the integration between the MEDITECH and 3M systems meant information had to be batch processed overnight, allowing the MEDITECH information to pass through the 3M software before it could be encoded, extending the coding and billing schedule.
Original Article: HERE
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