Rural New England Hospital
Increased critical care professional fees by approximately $125,000 per year
Developed feedback loop between the hospital billing office and the physicians to ensure that physician documentation supports the level of billing their work justifies.
Identified opportunities to optimize professional fees to reduce hospital subsidies for critical care coverage.
Removed barriers to change in current billing practice.
Identified future opportunities to increase the volume of critical care patients and ensure the capture of ventilator charges.
The ICU was serving as a medical/surgical overflow unit for 50% of the patients in the ICU.
The physicians did not always appropriately document their time spent on providing critical care or randomly billing codes were randomly applied.
The critical care time-based professional fees were not being billed because the billing office staff was not “comfortable” using these codes.
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