Question: How does your facility manage appropriate charging for observation hours, excluding any of the procedure times that are not permitted? What department is responsible? Are you using a log or average procedure times to carve out any observation minutes that are not permitted?
Answer 1: It is complicated to set up, but we are able to do the counting of hours minus procedures fairly well. We don’t have a log, but the times are in the electronic health record, and then checked by the health information management coder. Having a dedicated observation unit helps. When observation was initially done in a variety of locations, it was harder to be sure the staff was noting what they needed to in the electronic health record.
This question was answered by: Ruth Landé, vice president, patient revenues, Memorial Sloan-Kettering Cancer Center, and is a member of HFMA’s Metropolitan New York Chapter,
Answer 2: We have a department called charge integrity that reviews every observation account to ensure that we are in compliance and billing as required. They do a detailed audit on each account to determine what should be charged. We don’t do any averaging.
This question was answered by: Brenda Loper, regional director of access services for four Sentara Healthcare hospitals.
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