What is the true meaning of teamwork? It consists of a team of people who strive towards excellence, compliance, and reimbursement consistencies. Recently, a team of employees worked on the daily struggles of capturing the infusion and injection administration charges and should be recognized for all their diligent efforts.
What is the importance of capturing these charges? It ensures TGMC's compliance that the medical record is completed, supporting the coding and the billing, which ensures that the claim processing is not slowed down. Many infusions given were noted to have a start time, but not to have a stop time which reduced the ability to capture the correct charges. These missed charges are costly to TGMC's reimbursement for the services that they provide.
Daily audits were completed by the nurse auditor on the outpatient and observation accounts. Many missed infusion and injection administration errors were noted and becoming very costly to TGMC ranging from $10,000 to $35,000 in monthly charges that were unable to be captured. Once the audits were completed, communication on a weekly basis from the nurse auditor to the VP and the AVP of Nursing was crucial to correct the errors and educate the staff nurses.
The VP and AVP of nursing communicated with the nursing directors and educated their nurses on the importance of the issue at hand. IT personnel became involved with Ochsner's EPIC team in building these "stop times" for the infused mediations so the nurses became more aware of the necessary documentation needed in order to capture these charges. The need for complete and accurate documentation can be difficult to convey to the nursing staff because of their focus on patient care, but putting these "STOP times" on infusions can become very financially worthwhile.
Intense auditing, monitoring, communication, and educating staff on a daily basis has definitely been a performance improvement, significantly reducing the lost revenue and allowing TGMC to capture all possible charges. Lost revenue was noted from $10,000 to $35,000 monthly to almost $0.00. This is amazing teamwork and is something to be acknowledged.
Teamwork Makes the Dream Work!