Putting a Charge in Patient Care
Recently, Lisa Nolan, PatientKeeper’s director of product management, spoke with Sarah Elkins, a writer at For the Record magazine, about how physicians capture their charges.
“As a patient, I care very little whether my physician gets her charge in. I care how well they take care of me and how they interact with me,” Nolan admits.
Most physicians do care about entering their charges, but they also realize the less time they spend on charges, the more time they can spend with patients. So those tasked with improving charge capture at provider facilities should ask one question: How can I make this as easy as possible?
To that end, provider organizations should think creatively about charge capture, Nolan recommends. Look at ways providers can generate charges automatically – for example, by having inbound interfaces from other systems, so a provider can generate their charge while placing a medication order.
Of course, automation can’t happen if providers still use paper, and it’s surprising how pervasive paper remains in some environments – not so much in academic medical centers or community hospitals where physicians are employed and have access to all the systems, but elsewhere. “For example, the hospitalist groups that provide obstetrics support at community hospitals don’t have access to all the systems that employed physicians have, so they are making paper copies or taking pictures of notes, or keeping a piece of paper they write the charge code on,” Nolan says.
The impact of lost charges is obvious: a decrease in reimbursements. It doesn’t require an accounting degree to understand that leaving money on the table when margins are razor thin is a poor financial strategy. What’s less obvious is how significant the losses can be.
Nolan says consults are a frequent pain point when it comes to missed charges. “Physicians will either get ordered consults or fly-by consults or message-to-consult requests [that never get charged]. That’s significant dollars to an organization,” she stresses.
Failure to accurately capture charges impacts more than the facility’s bottom line—physicians are also negatively affected.
“We see more and more at our client organizations that [physicians are] compensated, at least partially, on RVU [relative value unit] values,” Nolan says, adding that when physicians forget to note fees or don’t enter the right charge, they lose salary supplements they would otherwise receive.
[This post is based on Sarah Elkins’s article “Through the Cracks”, published in the June/July 2019 issue of For the Record magazine.]