Singling Out Critical Access Hospitals
Enhanced functionality provides seamless rollover from outpatient to inpatient accounts.
August 1, 2013 - MEDITECH is excited to announce improved features for our Critical Access Hospital (CAH) customers! These new enhancements enable CAHs to bill separately for the outpatient and inpatient charges to maximize cost-based reimbursements from Medicare. Beginning with the 5.66 release, your MEDITECH EHR will maintain one account throughout the visit—preserving the integrity of clinical documentation for patient safety and allowing accurate billing for maximized reimbursement.
Seamless and Streamlined
To meet billing requirements, when a patient’s status changes from outpatient to inpatient, a rollover event is sent to the Billing/Accounts Receivable application (B/AR). Ancillary applications now send the rendering time, the service date, and the charge transaction to B/AR, indicating which procedures should be applied to the outpatient or inpatient claim.
Abstracting staff have the ability to code these charges separately at the time of billing for accurate reimbursement. Based on the patient’s event, Abstracting sends the surgical charges, CPT codes, diagnosis codes, and procedures to B/AR.
Rounding out the latest changes, a new Critical Access routine in B/AR provides a complete list of the account’s procedures—and whether they are outpatient or inpatient—which the biller can edit. Claim generation takes place seamlessly via the utilization of new claim checks and claim fields, which apply the charges to the corresponding outpatient or inpatient claim.
Smoother Transitions
Billing staff aren’t the only ones to benefit from the new, streamlined features. Clinicians also experience workflow improvements. Prior to this enhancement, here’s how one process impacted the care team: when an outpatient was admitted, the CAH would discharge the outpatient visit and create a new account for the inpatient visit. As a result, orders placed on the outpatient visit were stopped, requiring the provider to re-enter them on the new inpatient account. Nurses, pharmacists, and other ancillary staff had to re-acknowledge and re-verify the orders, disrupting workflow and frustrating clinicians.
Now, with MEDITECH 5.66, a single account can be used for patients who present as outpatients and are later admitted. Orders continue without disruption; if desired, physicians can use Provider Order Management’s Transfer routine to manage orders during the transition in level of care—ensuring continuity of care for the patient with minimal impact on staff.
Learn More
Interested in learning more? Read our 5.x Optimal Workflow Best Practices documentation for MAGIC and Client/Server.