The Impact of Outpatient Professional Coding on Third-Party Collections at Wilford Hall Medical Center
Abstract
The purpose of this study was to determine if a dedicated coding staff improves outpatient third-party collections at Wilford Hall Medical Center. To accomplish this, a review of the current procedures was undertaken in three key areas: identification of third-party health care insurance carriers, coding, and claims processing. Since the implementation of the Ambulatory Data System, there have been concerns over missed opportunities for third-party collections due to coding non-compliance. Providers and supporting staff were tasked with the additional administrative burden of coding patient visits. In 1999, Wilford Hall Medical Center hired ten coders and four clerks in an effort to improve ADS compliance and reduce this administrative burden. An additional benefit would be improving third-party collections. The study was designed to compare specified metrics before and after the hiring of the dedicated coding staff. A comparison was also performed% with the ambulatory areas that had no coding support for Fiscal Year 1999. Results showed that there were no differences in collection rates or days in accounts receivable. This was consistent when looking before and after the hiring of the coding staff and when comparing fiscal year 99 data that had no dedicated coding staff available. Coding compliance increased for all areas of the facility. The rate of identifying patients with "other health insurance" actually decreased hospital wide.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 01, 2000
- Accession Number
- ADA408442
Entities
People
- Paul W. Garden
Organizations
- Academy of Health Sciences