| Title | The devil is in the details: maximizing revenue for daily trauma care. | | Author(s) | Barnes SL, Robinson BR, Richards JT, Zimmerman CE, Pritts TA, Tsuei BJ, Butler KL, Muskat PC, Davis K, Johannigman JA | | Institution | Department of Surgery, University of Cincinnati, Cincinnati, Ohio, USA. barnesste@missouri.edu | | Source | Surgery 2008 Oct; 144(4):670-5; discussion 675-6. | | MeSH | Cost-Benefit Analysis
Documentation
Fees, Medical
Female
Financial Management, Hospital
Health Care Surveys
Healthcare Common Procedure Coding System
Hospital Charges
Humans
Insurance, Health, Reimbursement
Male
Medical Staff, Hospital
Patient Credit and Collection
Probability
Sensitivity and Specificity
Trauma Centers
Traumatology
United States
| | Abstract | BACKGROUND: Falling reimbursement rates for trauma care demand a concerted effort of charge capture for the fiscal survival of trauma surgeons. We compared current procedure terminology code distribution and billing patterns for Subsequent Hospital Care (SHC) before and after the institution of standardized documentation.
METHODS: Standardized SHC progress notes were created. The note was formulated with an emphasis on efficiency and accuracy. Documentation was completed by residents in conjunction with attendings following standard guidelines of linkage. Year-to-year patient volume, length of stay (LOS), injury severity, bills submitted, coding of service, work relative value units (wRVUs), revenue stream, and collection rate were compared with and without standardized documentation.
RESULTS: A 394% average revenue increase was observed with the standardization of SHC documentation. Submitted charges more than doubled in the first year despite a 14% reduction in admissions and no change in length of stay. Significant increases in level II and level III billing and billing volume (P < .05) were sustainable year to year and resulted in an average per patient admission SHC income increase from $91.85 to $362.31.
CONCLUSIONS: Use of a standardized daily progress note dramatically increases the accuracy of coding and associated billing of subsequent hospital care for trauma services. | | Language | eng | | Pub Type(s) | Comparative Study
Journal Article
| | PubMed ID | 18847653 |
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