核磁共振成像患者全麻术前检查表:提高报销的过程改进计划。

Q2 Nursing Health Care Manager Pub Date : 2018-07-01 DOI:10.1097/HCM.0000000000000222
Susan Hartl, Andi N Rice, Dhanesh K Gupta, Victoria Goode
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引用次数: 1

摘要

对于医疗保险和医疗补助服务中心等付款人的医院报销,完整的文件是必不可少的。如果工作流程没有标准化,特别是在涉及跨学科的情况下,可能会出现不一致和不完整的文档。对接受磁共振成像(MRI)麻醉服务的患者的记录进行了检查,并发现了改进的机会,以避免经济损失。实施了一个程序前检查表,以改进文档和标准化工作流程。我们比较了麻醉服务下干预前MRI和干预后MRI的记录。在程序前检查表实施后,符合报销要求的文件从干预前组的5%增加到干预后组的90%。一项费用估计显示,从实施前到实施后的潜在收入损失有所减少。在核对表的帮助下,工作流程的标准化有助于满足充分报销的文件要求,并减少了付款人可能报销损失的风险。
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Preprocedural Checklist for Magnetic Resonance Imaging Patients Undergoing General Anesthesia: A Process Improvement Plan to Enhance Reimbursement.

Thorough documentation is essential for hospital reimbursement from payors such as the Centers for Medicare & Medicaid Services. Inconsistencies and incomplete documentation can occur if workflow is not standardized especially in cases with interdisciplinary involvement. Documentation for patients undergoing magnetic resonance imaging (MRI) with anesthesia services was examined and revealed an opportunity for improvement to avoid financial losses. A preprocedure checklist to improve documentation and standardize workflow was implemented. We compared documentation from preintervention MRI to postintervention MRI with anesthesia services. Documentation that met the reimbursement requirements increased from 5% in the preintervention group to 90% in the postintervention group after the preprocedural checklist implementation. A cost estimate showed a reduction in potential revenue loss from preimplementation to postimplementation groups. The standardization of workflow with the aid of checklists helped meet the documentation requirements for adequate reimbursements and reduced the risk of potential reimbursement losses from payors.

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来源期刊
Health Care Manager
Health Care Manager HEALTH POLICY & SERVICES-
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期刊介绍: The Health Care Manager (HCM), provides practical, applied management information for managers in institutional health care settings. It is a quarterly journal, horizontally integrated and cutting across all functional lines, written for every person who manages the work of others in any health care setting. This journal presents practical day-to-day management advice as well as research studies addressing current issues in health care management. Its intent is the strengthening management and supervisory skills of its readers and increasing their understanding of today"s health care environment. HCM is searchable through PubMed.
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