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 Payers

Revolutionizing the coding and billing cycle with intelligent mobile technology

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   By Paul Adkison, May 2011

The rapid sophistication and adoption of mobile devices in healthcare has created an alternative to the traditional paper-based billing cycle.

Using intelligent mobile technology, providers have access via mobile devices to the patient's health information, lab results and other clinical data. The ability of mobile devices to allow physicians to access and interact with patient health information and clinical data has essentially become what many in the media have described as the new "black bag" of the physician.

Healthcare organizations that use mobile devices supported by coding intelligence have the potential to improve the financial performance of their respective organizations by millions of dollars each year.
A multitude of case studies have shown that capturing charges using mobile devices can increase revenue per provider by $20,000 or more per year, and significantly improve the revenue cycle management of virtually any healthcare organization. So why do so many healthcare organizations still rely on a paper-based system?

The challenges of a paper-based system

Complete and accurate clinical documentation is essential to providing quality care for patients and obtaining reimbursement for services. Unfortunately, in a paper-based billing system, coding and billing patient encounters consume a large quantity of caregivers' time and negatively impact their daily workflow. Paper-based billing also opens a Pandora's box of opportunities to make mistakes. Illegible handwriting, lost or misplaced sticky notes and limited writing space for capturing ICD and CPT codes create inefficiencies and bottlenecks in the revenue cycle. Coders and billing coordinators often find themselves trapped in a manual charge-verification cycle, impeding the billing and reimbursement process and costing healthcare organizations millions of dollars each year in uncollectable charges and wasted labor hours.

Paper-based charge systems also present a multitude of issues in terms of accuracy and timeliness of captured charges. Studies show that on average 15 percent of charges never get billed. In an outpatient environment, the caregiver usually has an administrative support system. With a list of appointments and a way to do manual reconciliation, charges are rarely lost or unaccounted for.

The inpatient environment is much more troublesome because it is dynamic. In any given day, there are opportunities to capture charges that can't be predicted. For example, a provider stops a colleague in the hallway and asks her to see a patient. The consulting physician may perform a procedure at the bedside, but there is no true record for the underlying coding staff to know if anything happened. The result: a billable charge is lost.

Moreover, providers have a tendency to procrastinate and delay documenting charges because it's an annoyance and interferes with their daily workflow. They let charges accumulate and then try to go back and capture charges for a period of time, relying on memory and sketchy notes to accurately remember what they did. Inevitably, they will leave out procedures and consults that should have been billed, but are not. By the time the coders get the charges, it's a week or two after care was rendered, making it difficult to find out exactly what happened at the point of care.

Revolutionizing the billing and coding cycle with mobile technology

Fortunately, there is a way today to capture point-of-care charges in a method that not only saves time for practices, providers and hospitals, but that also significantly improves revenue. Many healthcare organizations have begun to trade handwritten notes and little pieces of paper for mobile applications that enable the capture of charges — in compliance with billing and coding rules — as they happen. This not only speeds up delivery of billable charges to the back end, but it saves time and money and allows for a more efficient capture of revenue.

Mobile devices — when supported by a sophisticated, intelligent mobile enterprise platform and coding intelligence system — give providers the opportunity to view detailed, relevant patient information in real time at the point of care, and to capture and digitally submit charges to their billing system as they happen. Providers no longer need to rely on handwritten notes or index cards to capture charges, only to try to later recall the details of an individual patient visit; or even worse, not capture a charge at all for the consult.

For instance, Carrollton Surgical Associates, a provider of surgical care to residents of Georgia and Alabama, increased its revenue by 20 percent by using a mobile healthcare platform to capture billable charges and view detailed patient information at the point of care.

Mobile technology has the ability to simplify the daily workflows of coding and billing staff, as well. This vital support group has a very challenging task in the traditional paper billing cycle. They spend much of their time sorting through physician paper notes, which are often illegible or difficult to reconcile because by the time they receive the charges, several weeks have passed since the patient consult occurred. Consequently, coders spend much of their time speaking with physicians trying to clarify and reconcile charges that were captured weeks ago.

Using mobile technology supported by coding intelligence not only allows charges to be submitted to coding staff in real time at the point of encounter, but also allows submitted charges to be automatically reviewed for accuracy using an intelligent rules-based coding engine, prior to receipt by coding staff. In this advanced workflow, sending digital charges eliminates weeks in the queue (not to mention cash flow sitting in accounts receivable). The charges have already been reviewed for accuracy by an intelligent coding engine, so all that is left for the coder to do is to make a final review and submit for billing.

The rapid sophistication and adoption of mobile devices in healthcare has created an alternative to the traditional paper-based billing cycle and all of its aforementioned deficiencies. According to Manhattan Research, 81 percent of physicians will be using a smartphone by 2012. Mobile devices have evolved over the last 10 years to become robust computing platforms that offer a wealth of opportunities for healthcare providers to access and interact with all kinds of clinical and patient information at the point of care, or while on the move in any care environment.


Paul Adkison is CEO and founder of IQMax
(www.iqmax.com).
For more information on
IQMax solutions:
www.rsleads.com/105ht-207



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