In the COVID-19 era, reducing accounts receivable days and achieving accurate reimbursement is more critical than ever, according to Lucian Newman III, MD, a general surgeon at Gadsden, Ala.-based Surgery Clinic and the chief medical information officer for Nuance Communications.
During an August 2020 webinar sponsored by Nuance and hosted by Becker's Hospital Review, Dr. Newman discussed the financial effects of unbilled procedural notes and how practices can recapture lost revenue through an improved documentation system.
Other speakers included:
• Eric Van Lewis, MD, orthopedic surgeon, Orthopedic Institute of North Mississippi (Tupelo)
• Michael Damrich, account executive, Nuance Communications
Four key takeaways from the webinar:
1. Small details make a significant impact. Over the past 25 years, the focus on coding in medicine has been with the evaluation and management system. But the method for creating procedural notes has been neglected, according to Dr. Newman. "Surgeons most often know the answers to the questions that the coders might have, but very often don't know the questions," he said. "It's simple and time-effective to answer those questions by taking notes at the point of care," but you need a solution that's fast, has memory, and that surgeons will use.
2. Unbilled procedural notes have significant financial impacts. Surgeons who don't accurately enter their procedural notes commonly leave out important descriptive words, such as "extensive" or "complicated," Dr. Newman said, which ultimately affects the bottom line. For example, the following are the average charges and relative value units of an excision of a pilonidal cyst at varying levels of difficulty, based on data from Blue Cross Blue Shield Alabama:
Simple: $482/RVU 2.66
Extensive: $624/RVU 6.09
Complicated: $948/RVU 7.35
3. The Nuance Surgical CAPD solution decreased annual documentation expenses by $40,000 and average accounts receivable (A/R) by eight days at North Mississippi Health Services, a surgery center where Dr. Van Lewis' practices. The system is designed to streamline surgeon workflow, manage high transcription costs and improve average AR. "With this system, in the time it takes me to walk from the OR to see my next patient, I've already done an op note," he said.
4. The application is equipped with a voice-to-text tool to facilitate transcribing through a mobile device. "As [physicians] continue to dictate, the application is learning from what they have documented," Mr. Damrich said. "We as a team are maintaining and updating all of the questions that get asked on a quarterly basis," which eases the burden of the medical record team to tap providers for documentation specificity.
Click here to learn more about Nuance and here to view the full webinar.