A little help from my fellow ED nurses!

  1. I know, I know .... Billing is boring! I was recently volunteered to become a member of a committee at work whose aim is to revamp our nursing billing (or technical billing) charges. We believe that our current system of billing is not user friendly and we may be missing charges. I was looking for input from my fellow ED nurses as to how you bill for your services. At this point we use # of specimens, # of meds, ancillary departments used, and few other things such as education and nurse assessment to decide level of care and then pick from a list of procedures/equipment (moderate sedation, splinting, cath, etc) that can be charged for. It's not pretty. Can anyone give me a rundown of your procedure or template? Thanks in advance!
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    About jme5097

    Joined: Apr '13; Posts: 2


  3. by   hherrn
    Nope. I can't help with a template or system.

    I work with an unfriendly system, and I can pretty much guarantee that when I go into work today, the hospital will lose revenue as a result. The RN in my department who takes the lead on this stuff is an outstanding RN, but not really all that tech savvy. When difficulties are pointed out, her general response is to explain why they can't be fixed.

    Let's say today that I do a complex dressing, or splint. In order for me to document this properly, I will need to sort through about a dozen screens with obscure codes. Splint will not be under "splint". In all likelihood, it will be "aasplintproc", or something. No cross reference. If I have the time, I'll sort through the codes to find it. If I am busy, and don't find it easily, I'll document it in a note, which may well be missed by coding, and not billed. I am fairly sure a cross referenced list based on easily remembered and commonly used terms could easily be developed. For example, tying "bs", fsbs", "fingerstick", "glucose" would all trigger the same code.

    This is ridiculous. Imagine if Mcdonalds was losing revenue because of difficulty using a badly designed program. If the IT guy said "sorry, there is no way to fix that", the next thing he would be saying would be "want fries with that?"

    Imagine what a hospitals documentation/billing system would look like if it was designed by somebody with incentive to make it work well: $1 for every time a nurse uses it right and the hospital gets re-imbursed. A call, at home, every time a nurse had difficulty with the system.

    What I would encourage is to develop a system that can easily be tweaked and adjusted with RN input. Actually watch people use it, and if they are struggling, change it. It is astounding that hospitals let charges slip through the system because of lousy computer programs.
  4. by   ChristineN
    You guys make me really glad that nursing doesn't do the billing in my ER. We have an order sheet (including standing orders that we just time and initial if we do) and an out processing form that goes to billing and they deal with it.