Discrepancies between coding data and clinical registry data can significantly impact reimbursements in a cardiac services department — yet many health systems are unable to recognize these missed revenue opportunities without a comprehensive coding audit.
The hbRecon solution was selected by the following three hospitals to help identify and resolve these discrepancies in their cardiac services billing departments. Here, we share their experiences and explore how hbRecon’s clinical registry data-based audits helped build a more profitable and efficient cardiac services department in each organization.
Evaluating the hbRecon Impact: Explore Three User Experiences
1. How does your hospital use clinical registry data?
- Jerod Weimer, Bakersfield Memorial Hospital: We use the registries to measure, monitor, and improve our patient care and outcomes.
- Kerry Webb, Chandler Regional Medical Center and Mercy Gilbert Medical Center: We use our data for measuring performance, quality goals and performance improvement.
- Beth Kennalley: To measure and monitor clinical performance, quality goal performance, and performance improvement activities.
2. What do you find most valuable about collecting registry data?
- Jerod Weimer, Bakersfield Memorial Hospital: The ability to keep our “finger on the pulse” of the systems involved in our patient care and program performance.
- Kerry Webb, Chandler Regional Medical Center and Mercy Gilbert Medical Center: The data helps to identify any processes that may need to be improved and usually end up uncovering other things that can use improvement.
- Beth Kennalley: Identifying performance opportunities and excellence.
3. How has hbRecon fit into your current processes and workflows?
- Jerod Weimer, Bakersfield Memorial Hospital: hbRecon has allowed us to expand the awareness and performance of our documentation and interdepartmental working relationship by closely tying the clinical data to the administrative data.
- Kerry Webb, Chandler Regional Medical Center and Mercy Gilbert Medical Center: It fits in looking at and reviewing the data when I have a chance. Sometimes, it is right after it is uploaded, and other times, it takes a week or two.
- Beth Kennalley: hbRecon is a monthly review of any abstraction and coding differences on both our Open Heart and CathPCI cases, and has taken less and less time as we have improved performance in both areas. It allows me to quickly and accurately review both data sets to ensure they accurately reflect the case that was performed.
4. What do you find most valuable about using hbRecon?
- Jerod Weimer, Bakersfield Memorial Hospital: hbRecon’s most valuable impact has come from increased accuracy in both clinical and administrative documentation.
- Kerry Webb, Chandler Regional Medical Center and Mercy Gilbert Medical Center: hbRecon has helped identify documentation issues on the physician’s end. It has also helped our coding team to improve their system when it or the people are combing through the charts.
- Beth Kennalley: The ability to compare two independent chart abstractions is invaluable but would take too much time to do manually to be useful. This tool allows us to do this and find multiple errors in a short amount of time, and to submit this information for correction in a timely manner. The tool has allowed us to be reassured that our billing is accurate in these areas.
Realize These Financial and Operational Benefits in Your Organization
Each of these hospitals’ experiences highlights the critical importance of accurate coding for cardiac services, as well as the challenges of comprehensively capturing the services provided during each episode of care. The hbRecon toolkit equips health systems with a more granular audit based on clinical registry data to reduce under and over-billing, accurately reflect patient acuity and case mix index (CMI), and drive proper reimbursements. Through step-by-step improvements in coding quality, with a core focus on enhancing interdepartmental collaboration, hbRecon is helping health systems maximize accurate revenue capture for their cardiac services.
Want to learn more? Schedule a demo to discover how hbRecon can improve cardiac services profitability in your health system.