The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

REDUCTION IN DENIED PAYMENTS WITH THE INITIATION OF PAPERLESS DOCUMENTATION SYSTEM TIED TO BILLING.

John S. Emberger, Francis Gott III, Joel M. Brown II; Respiratory Care, Christiana Care Health System, Newark, DE

BACKGROUND: There are many benefits to an electronic documentation system. One of the benefits is to tie billing directly to documentation and reduce denied payments or medical audit bill adjustments for respiratory care services. Respiratory Care at our hospital system converted to an electronic documentation system tied to billing from a separate paper documentation and electronic billing system in July 2008. Once converted, we were 100% paperless for documentation. We acquired wireless computer carts and began live electronic documentation. We wanted to determine if denied payments for respiratory services were reduced after initiating a electronic documentation system. METHODS: We conducted a retrospective review of respiratory service denied payments in which our auditing department reduced hospital bills due to services that were charged but were not supported in the documentation. We retrospectively reviewed 4 months prior to electronic documentation (April - June 2008, PRE period), 4 months after initiation of electronic documentation (July - October 2008, POST period) and the 4 most current months (February - May 2012, CURRENT period). RESULTS: See the chart for monthly denied payments before and after initiation of the electronic documentation system. Average denied payments were $11,028 per month in the PRE period, $2,526 in the POST period and $1,806 in the CURRENT period. Denied payments dropped by more than 75% after initiation of electronic documentation system. CONCLUSIONS: Initiation of an electronic documentation system that ties charges directly to clinical documentation can reduce denied payment charges or audits that adjust charges. We demonstrated that current denied charges remain as low as right after initiation. An electronic documentation system can contribute to financial strength of an institution as well as reduce risks associated with charging for services that are not supported by documentation and thus are audited or denied. Sponsored Research - None Denied Charges for Respiratory Care services by month before and after initiation of electronic documentation tied to charges.