Charge Capture at Discharge

[Kenmore1009]

As part of our electronic medical record (Epic), at time of discharge RN's are required to check off supplies that were used during a patient's stay in the ED. This is so patients can be charged accurately for what supplies were used.

I understand that reimbursement for services is extremely important, especially in the system of health care we have in the US. My initial reaction to this requirement, though, is that it is outside the role of an RN to provide care and also be involved in the billing process of my patients. Shouldn't there be another person, from a billing department, who can review documentation to complete the billing process? Does anyone else see some potential ethical conflicts with RN's being involved in the billing process in this way?

[pockunit, ADN, RN]

How would anyone know what was used if the nurse doesn't record it? Nurse would have to record it somewhere for that other person to do it. Why not just input it as is currently being done?

I would assume that a catheter was taken out and used if one was ordered and charted. If a pt got a neb, it seems to follow that neb treatment should be charged. That seems easy enough to figure out and charge for.

My beef is that we end up double charting because EPIC doesn't drop charges when we chart. It's incredibly annoying. I have to chart the assessment; that should trigger a charge just like when I hang blood.

On top of that, we receive very spotty education on how to charge for infusions/injections (if your preceptor thinks to do it, you might get some training). Facilities that want to be paid the max should have people trained to capture those charges. Since they don't offer that training, they lose a ton of money. When it becomes a priority, they'll staff accordingly. Until then, they get what they get and if it's crazy busy, I'm a lot less careful and thoughtful in how I charge, because patient care and all that silliness.

[aflahe00]

Yep welcome to healthcare 2017. Everything is about money and where resources are going. Constantly trying to find ways to save money but also I don't see an issue with billing patients for services they received.

[Muser69]

We still have stickers that you place on a card. I haven't placed any stickers for more than 25 years