The Impact of a Standardized Consultation Form for Facial Trauma on Billing and Evaluation and Management Levels

Levesque, Andre Y.; Tauber, David; Lee, Johnson C.; Rodríguez-Feliz, Jose; Chao, Jerry

doi:10.1097/sap.0b013e31825c0871

Cited by 4 publications

(4 citation statements)

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“…11,13,14 A variety of teaching methods for practice management have been studied, ranging from lecture series to educational weekend retreats, with varying degrees of success. 8,[14][15][16][17][18][19][20][21] The purpose of this study was (a) to determine the current level of knowledge of surgical resident physicians on topics relating to billing and physician remuneration, (b) to compare the accuracy of residents' billing with the accuracy of the billing of staff physicians already in independent practice and (c) to explore resident and staff physician experiences and opinions regarding practice management education during residency training.…”

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confidence: 99%

How accurate are we? A comparison of resident and staff physician billing knowledge and exposure to billing education during residency training

Austin

Schroeder

2019

cjs

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Background: Practice management is an overlooked and undertaught subject in medical education. Many physicians feel that their exposure to billing education during residency training was inadequate. The purpose of this study was to compare resident and staff physicians in terms of their billing knowledge and exposure to billing education during residency training. Methods: Senior residents and staff physicians completed a scenario-based clinical billing assessment. Posttest surveys were completed to determine exposure to practice management and billing education during training. Results: A total of 16 resident physicians and 17 staff physicians completed the billing assessment. Overall, the billing accuracy of respondents was poor. Staff physicians had a greater percentage of correct billing codes (55.3% v. 37.5%, p < 0.001) and underbilled codes (6.2% v. 3.4%, p = 0.009), with fewer missed billing codes (38.5% v. 59.1%, p < 0.001), compared with resident physicians. The percentage value of correct billings was significantly higher for staff physicians (71.5% v. 56.8%, p = 0.01). In the posttest survey, 100.0% of residents and 79.0% of staff physicians desired more billing education during training. Conclusion: In general, staff physicians billed more accurately than resident physicians, but even experienced staff physicians missed a substantial amount of potential revenue because of billing errors and omissions. The majority of the residents and staff physicians who participated in our study felt that current billing education is both insufficient and ineffective. Incorporating practice management and billing education into residency training is critical to ensure that the next generation of medical trainees possess the financial competence to required to manage a successful medical practice. Contexte : La gestion médicale est un sujet souvent oublié et trop peu enseigné durant les études de médecine. Beaucoup de médecins ont l'impression que la formation sur la facturation offerte durant leur résidence était insuffisante. L'objectif de cette étude était de comparer les connaissances sur la facturation et l'exposition, durant la résidence, à la formation sur ce sujet des résidents et des médecins membres du personnel. Méthodes : Les résidents seniors et les médecins membres du personnel ont effectué une évaluation de facturation clinique à partir de mises en situation. Ils ont répondu à un sondage après le test pour déterminer leur exposition à la formation sur la gestion médicale et la facturation durant leurs études. Résultats : Au total, 16 médecins résidents et 17 médecins membres du personnel ont fait l'évaluation de facturation. Dans l'ensemble, l'exactitude de leur facturation était faible. Les médecins membres du personnel avaient un pourcentage plus élevé de codes de facturation corrects (55,3 % contre 37,5 %, p < 0,001) et de codes de facturation insuffisants (6,2 % contre 3,4 %, p = 0,009), et avaient moins de codes manquants (38,5 % contre 59,1 %, p < 0,001), comparativement aux médecins résidents. L...

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confidence: 99%

How accurate are we? A comparison of resident and staff physician billing knowledge and exposure to billing education during residency training

Austin

Schroeder

2019

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“…Standardized template notes have been shown to increase billing and coding in the trauma surgery and facial trauma literature. 8 , 9 Barnes et al implemented standardized daily trauma surgery progress notes, noting a subsequent 394% increase in revenue. 8 However, the E/M coding for inpatient daily progress notes does not meet the same requirements as initial consultations.…”

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confidence: 99%

“…10 , 11 We showed a 22.8% increase in total billing charges, which is comparable to the 28% increase noted by Levesque et al in the facial trauma population. 9 Of note, these data represent billing charge, not revenue collected. Revenue collection was not recorded, as these values vary significantly based on insurance status, insurance carrier, and insurance payment schedules.…”

Section: Discussionmentioning

confidence: 99%

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Quality Improvement: Effect of Standardized Plastic Surgery Consultation Note Templates on Charge Capture

Schaeffer

Park

Lane

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Effective medical record documentation is imperative for both patient care and reimbursement for care provided. The purpose of this study was to compare coding/billing patterns for plastic surgery consultations before and after implementation of a standardized documentation protocol. Methods: Standardized hand, facial trauma, and general plastic surgery consult note templates were created. Following institutional approval, records were reviewed for all plastic surgery consultations from January to October 2019. Template notes were universally implemented in July 2019. Medical coding was performed by a certified professional coder using the 1995 Evaluation and Management Review Worksheet. Coding/billing patterns between groups were compared with and without standardized documentation using univariate analysis. Results: Seventy-five consecutive preimplementation consult notes and 75 consecutive postimplementation consult notes were selected for review. Each group included 25 hand, 25 facial trauma, and 25 general plastic surgery consultation notes. The history and physical examination components of the visit code were more frequently coded as “comprehensive”postimplementation (P = 0.000). There was no significant difference in coding for medical decision making between the two groups (P = 0.340). The final visit code was significantly higher in the postimplementation group (45.3% 99254/99284 versus 2.7%, P = 0.000), and the charges were significantly higher post implementation—average charge per consult $250 versus $203 (P = 0.000) with a 22.8% increase in total charges generated. Conclusion: Utilization of standardized consultation note templates increases the accuracy of coding and associated billing of inpatient and emergency department plastic surgery consultations through documentation and reflection of level of service provided.

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Commentary on “Medicare Reform of Hospital Payment for Inpatient Facial Plastic Procedures” by Kondamuri et al.

Lafer¹,

Buckingham²

2021

Facial Plastic Surgery & Aesthetic Medicine

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The Impact of a Standardized Consultation Form for Facial Trauma on Billing and Evaluation and Management Levels

Abstract: In our institution, the development and implementation of a facial trauma consultation form has resulted in more complete documentation and a subsequent increase in EM level and billed services.

Cited by 4 publications

References 3 publications

How accurate are we? A comparison of resident and staff physician billing knowledge and exposure to billing education during residency training

How accurate are we? A comparison of resident and staff physician billing knowledge and exposure to billing education during residency training

Quality Improvement: Effect of Standardized Plastic Surgery Consultation Note Templates on Charge Capture

Commentary on “Medicare Reform of Hospital Payment for Inpatient Facial Plastic Procedures” by Kondamuri et al.

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