Capture Lost Hospital Activity Revenue, Improve Your Bottom Line
Published on Mon Jun 01, 1998
One of the major areas of lost revenues in an ob/gyn practice is services and procedures performed in the hospital but never billed for, says Jan Rasmussan, CPC, coding consultant and instructor for Med Learn, a medical practice management training and consulting firm in Eauclair, WI. Its the one area that is difficult for the ob/gyn clinic coder to track. Actually, no one seems to know exactly how extensive the problem is or exactly how much revenue is lost, but in talking with a number of consultants, ob/gyn practice managers and coders and ob/gyns, all acknowledged that it was an area where most practices could use help.
Most ob/gyn offices are quite familiar with the problem. Typical scenarios include: an ob/gyn rushes to the hospital at the end of a busy day to deliver a baby. Theres no problem there, the patient is covered under a global ob charge. But following the delivery, the physician heads up to see a gyn patient on a medical floor, and after a quick report from a nurse, decides to perform a minor procedure on the patient. Just as the ob/gyn is about to leave the hospital, he or she gets a page from the ob floor and ends up heading back to the ob department to address a problem with a different ob patient who delivered the night before. By the time the doctor leaves the hospital, his or her office is usually closed and the staff has gone home. So the ob/gyn also heads home.
The next day begins with rounds and then a full clinic schedule. By the time the doctor takes a break, the procedure performed on the gyn and ob patient the night before has been forgotten and thus is never brought to the attention of the coding staff. Clinic coders at best only have limited knowledge of what goes on in the hospital if the physician does not bring the information back to the clinic.
Hospital Activity Tracking Tips
How ob/gyn practices track hospital activity varies greatly based upon the size of the office, the needs of the physicians and other healthcare providers (CNMs, NPs PAs) and their relationship with the hospitals. We found a number of different methods being used to track hospital activity with varying degrees of success.
Method #1: Many practices are still using a form (often a small card) in which the physician records the name of the patient, the days the patient was seen in the hospital and what was done for her. Some of the forms have commonly used CPT and diagnosis codes on them for easy reporting. The physician records the data and brings the cards back to the office staff at [...]
