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Critical Access Hospital captures more revenue, simplifies coding with Allscripts Intelligent Coding

According to a Medscape survey, approximately 44% of emergency medicine physicians are burned out. Top contributors of burnout among all physicians include having too many bureaucratic tasks and the increasing computerization of medicine. These stressors not only add burdens to providers’ workloads. They can also lead healthcare organizations to leave money on the table, hindering their ability to provide quality patient care.

This was the situation WhidbeyHealth Medical Center faced in its emergency department (ED). Based on Whidbey Island in Washington state, the certified Critical Access Hospital (CAH) handles a substantial volume of high-intensity cases in its ED. Leadership noticed that the organization was not being reimbursed at expected levels due to differences in how providers documented Current Procedural Terminology (CPT®) codes.

“It was a constant struggle to get consistent documentation from our providers at the right levels,” Debra Tesch, manager of health information management and privacy officer at WhidbeyHealth Medical Center, said.

To streamline its coding processes and maximize revenue capture, the hospital decided to implement Allscripts Intelligent Coding™, a software tool that helps optimize CPT charge capture, appropriate visit level evaluation and management (E&M) assignment and adherence to guiding principles from the Centers for Medicare and Medicaid Services (CMS).

“Staff members love it,” Tesch said. “It enables them to really understand the criteria and points them in the right direction. It’s a really easy tool to use once you understand it.”

In addition to simplifying coding processes, Intelligent Coding gave the hospital new reporting mechanisms. These enabled the health information management team to assess how providers were coding and make adjustments at the individual level as needed. “Now that we have the data, we can work one-on-one with our providers to look at where they fall into their levels compared to their peers, as well as critical care documentation,” Tesch said.

With these capabilities in place, the organization was able to receive adequate reimbursement for services rendered. Its per patient visit charge increased by 21% in just 90 days, putting the organization in better financial standing to continue serving the Whidbey Island community.

To learn more about how Intelligent Coding transformed the revenue cycle for WhidbeyHealth Medical Center, read the full client success story here.

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