The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Joyce Baker; ChildrenÂ’s Hospital Colorado, Aurora, CO

Background: In 2008 it was identified a significant amount of salary expense, a total of 120 hours a month, was being paid for several staff therapists to recover an average of 8.12% in missed billable procedures and equipment. These hours and salary expense were equivalent to a .45 FTE dedicated exclusively for revenue recovery. Methods: Starting in January 2009 a department financial goal to decrease lost revenue by 3% was set and cascaded to all staff, with the end target for December 2009. This would be achieved through identifying barriers to billing consistency, ongoing education, timely follow up around inappropriate billing and staff empowerment. An average of 167 various treatments were audited each month to track progress, identify inconsistencies, and measure trends. From the audits one on one education was done with employees who had consistent discrepancies in billing; solicited feedback from staff around regular barriers to billing were identified; and changes in processes were implemented in the electronic medical record (EMR). An employee database was built to provide each employee the opportunity to track their variances in billing practices, empowering them to seek out information, and have ownership on impacting the overall department financial goal. Results: From 2008 to 2009 there was a 3% improvement in billing practices, resulting in the department meeting the financial goal for 2009. Ongoing tracking of billing accuracy beyond 2009 has resulted in further noted trends directly related to hiring of new staff, increase inpatient volumes, and ability to implement additional EMR changes to minimize human error. Conclusion: By implementing a department wide goal where every member is held accountable; providing prompt follow up around variances in billing; identifying barriers specific to billing; and minimizing the barriers within the EMR we have been able to improve billing practices by 6% over a three year period. As a result of these billing improvements we were able to decrease hours paid to recover revenue from 120 hours a month to 48 hours a month, a 50% reduction in hours or decrease in paying a .28 FTE specifically to revenue recovery. Sponsored Research - None