After standardizing its second-opinion workflow, the radiology department at Columbus-based The Ohio State University Wexner Medical Center achieved a reimbursement success rate of 91.9%, according to a study published June 24 in the Journal of Imaging Informatics in Medicine.
Researchers at the medical center identified inefficiencies in its second-opinion workflow that were leading to “suboptimal” reimbursement. They addressed the inefficiencies by leveraging existing tools in the EHR to standardize the second-opinion process.
Here are three notes on their findings:
- The workflow changes were implemented in August 2021.
The first step was to automate the process of linking outside imaging data to the appropriate patient EHR. Once this step occurs, and a second-opinion order is placed, the department’s administrative staff conduct and monitor a standardized second-opinion worklist to ensure the order is medically necessary.
Once an order has been approved, an automated specialty-specific worklist is populated for radiologist teams. Radiologists complete the order using standardized templates within the center’s existing reporting software.
“Using standardized reporting templates and having an indication of medical necessity for the second opinion together allows for the original work relative value unit of the CPT code of the outside study to be documented and used for billing,” the study authors wrote. - Researchers analyzed reimbursement data from August 2021 to October 2022 and surveyed physicians to assess any effect from the workflow changes.
Survey respondents reported improved user-friendliness, timeliness and workflow efficiency.
The workflow changes resulted in a 91.9% collection success rate. - “Standardizing the second-opinion workflow enhances operational efficiency, user satisfaction and reimbursement, thereby improving patient care,” the study authors wrote.
Read the full study here.
