Practice Management Alert

No matter how many claims you send out, if your practice fails to capture all its charges, you're going to lose revenue. Physician services rendered in the hospital are a big source of missed charges. Although most practices have a system to produce charge tickets for surgeries, many lack a system for physicians to communicate to their billing departments what they did during hospital visits and consultation.
 
"Most practices have an encounter form, encounter ticket, a charge slip, a charge ticket, fee slip, or whatever they may call it that contains common codes that the physician checks off to indicate what services were rendered while seeing a patient," says Jennifer Bever, MS, a consultant with Karen Zupko & Associates Inc., a health-care consulting firm based in Chicago. "Practices have one for their offices, and one for their surgeries. But, they frequently don't have a charge ticket for their hospital visits, and that's the problem." As a result, E/M codes for inpatient, follow-up, emergency-room and consultation visits often aren't reported to the practice's billing department.
 
Without an inpatient-charge capture system, physicians who try to report their hospital charges submit random slips of paper sometimes containing indecipherable handwriting to their billing departments. "When the physicians don't have a charge ticket, they write things on Post-It notes, napkins, fact sheets from the hospital system, or labels the hospital prints that may be attached to the chart, and anything," Bever observes. Some of those bits of paper get lost, and others aren't sent to the billing department for weeks, she adds.
Develop Hospital-Charge Capture System
To solve these problems, set up a standard system to capture hospital charges, Bever advises. You can either add inpatient E/M codes to your surgical charge ticket or create a dedicated, hospital-visit charge ticket. On a hospital-visit form, include spaces for the patient's name and date of birth, place of service, date of visit, date of procedure, a list of hospital E/M codes, and space to write diagnoses. Print the charge ticket on cards that will fit in the doctor's lab-coat pocket, and ask that they be turned into the billing department regularly. "I've seen them spiral-bound so the doctor could keep track of multiple patients for multiple days for a week, and then turn in their book each Friday," Bever says. Some practices use different-colored charge-ticket cards for each hospital. Similar charge-ticket systems could be developed for physicians to capture charges during nursing-home visits.
For such charge-ticket systems to work, Bever admits, the practice has to expect that the physicians will use the cards and turn them in by a specific time. "Another problem occurs when the physicians capture all the charges but don't turn them in on time. This [...]