Improving the Emergency Department's Processes of Coding and Billing at Brooke Army Medical Center
Abstract
The Army Medical Department's (AMEDD) method by which it obtains reimbursement for patient care is undergoing a major transformation. Beginning in October 2002, outpatient itemized billing was mandated for use in the AMEDD. This system shifted the process of billing for outpatient services from an allinclusive rate to one based on the actual care provided. This has placed focus on medical coding, which is transposing documented care into an alphanumeric format that is acceptable for billing purposes. As the primary portal into Brooke Army Medical Center, the emergency department (ED) is being forced to streamline its processes and operate on a more cost effective and efficient basis. This is a challenge as they are the only level one trauma center in the United States Army and treat a high volume of high acuity, diverse patients. The ED sees over 56,500 patients annually, five-percent of which are non-beneficiaries, and accounts for over 60 percent of all hospital admissions. The continuous inability to comprehensively bill for services has resulted in the ED being a major cost center for the hospital. In 2002 the ED provided over $1.25 million of billable care of which only $324,000 was actually billed. This was due to poor data entry, documentation, and coding. The ED is seeking methods to control expenditures, improve documentation, and increase coding compliance and subsequent billing. Medical treatment must be documented and efficiently coded to be billed and reimbursed. Medical coding is now the lynchpin for reimbursement.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 02, 2003
- Accession Number
- ADA421418
Entities
People
- Peter A. Lehning
Organizations
- Academy of Health Sciences