GREENVILLE, SC – Emergency departments – gotta have ‘em, and gotta lose big money in the process.
While hospitals are obligated to provide emergency care services, most have a limited ability to collect payments for those services, for a well-understood variety of reasons. At least one hospital system is trying to do something about that trend.
The Greenville (S.C.) Hospital System is seeing improved financial performance for the emergency departments in its four hospitals by using automation to more quickly compile medical records. This results in quicker and easier submission of bills to payers, facilitates the compilation and sharing of information, accelerates the pace of care and makes workflow easier, saving additional money.
In the first two years of using the PulseCheck information system in Greenville’s emergency department, billable gross revenue increased by $22 million, and with a return of about 30 cents on every dollar billed, collections increased by about $7 million, said Charlene Ertzberger, ER system coordinator.
With PulseCheck, from Wakefield, Mass.-based Picis, Inc., patient information and provider care is recorded at every step of the process, beginning with intake.
The application provides records that are legible and organized, so that patient handoffs are facilitated and clinician diagnoses and orders are understandable. Each step of care is recorded, which ensures that no treatments are forgotten when it comes time to bill.
“The bills are more accurate because you can read what has been done,” Ertzberger said. “It used to take days to get charts to the coders, who were in another part of the state. We would have to bundle the charts and pay a courier service to get it to them. They would have to sort through them and then code them manually into a different system. Now, these coders use PulseCheck remotely and just log into the record itself.”
Payers often have strict guidelines for receiving bills in a timely manner, and computerization has helped Greenville meet its deadlines, Ertzberger said. “Insurance companies want things within a certain number of days, and with paper charting, it always took a lot longer.”
There were other gains as well. Lengths of stay in Greenville ERs declined systemwide, resulting in better care, higher throughput and additional cost savings, she said.
Handoffs for inpatient treatment also are facilitated, because ER records are legible and immediately in the hospital. Picis is working on an interface to improve the transfer of the information to its inpatient information system.