C3: A comprehensive physician activity and billing tool

Area of Science:

• Health Informatics
• Medical Billing Systems
• Academic Medical Centers

Background:

• Physician activity and billing tracking in academic medical centers often involves inefficient, paper-based processes.
• Ensuring accuracy and timeliness in charge capture is crucial for revenue cycle management.

Purpose of the Study:

• To develop and evaluate the Clinical Charge Capture (C3) system for enhancing efficiency and accuracy in physician activity and billing.
• To streamline documentation, charge capture, and data collection in an academic medical center setting.

Main Methods:

• Implementation of an Oracle-based, Visual Basic system integrating various hospital databases (scheduling, transcription, clinical data, IDX).
• Utilized paperless, on-line functionalities for preauthorizing procedures, creating bills with diagnoses, and submitting charges.
• Incorporated a messaging system for physician-billing specialist communication and barcode technology for outpatient clinic charges.

Main Results:

• Reduced average time to bill submission for operative procedures from 40 days (Pre-C3) to 8 days (Post-C3).
• Achieved a 9% increase in the average bill amount per primary charge submitted.
• Demonstrated improved accuracy and completeness in bill delivery by flagging missing data.

Conclusions:

• The Clinical Charge Capture (C3) system significantly enhances the efficiency, accuracy, and organization of physician documentation and billing.
• The system's integration capabilities and streamlined workflows contribute to improved financial performance and data management.
• C3 serves as a valuable tool for clinical information research, in addition to its primary billing functions.