A second thought about Big Data, EMRs and healthcare collaboration.
Another plausible explanation is that the management of Big Data is doing what it is supposed to do. However, the unintended consequence is that billings increased.
Maybe what has been discovered is that a whole lot of free care is now being caught in the documentation sieve. Rightful reimbursement is given for work done now, it is just that no one was aware of it before.
Below is a non-medical analogy involving 3 ways to act when a stranger approaches and asks for directions. Assume the stranger is not a native speaker.
#1. You tell him the directions -- walk one-half block until you see the store with the red front, turn right. You bill for Code ZDP994564.
#2. You quickly and sternly walk him to the corner, a half block away, and point down the street. You bill for the same code, and add the modifier -- 77 because you are completing the EMR form to exactly describe what you did.
#3. Or, you smile, ask him where he is from and how his visit is going, walk him down to the corner, turn right, and walk with him another half a block until he sees what he is seeking. Was there a modifier for that? Was that billable as “public relations," assistance at a higher level, or counseling?
In either of the 3 ways, you provided a service. If you coded at different levels, isn't that what was asked for? The Garbage-In is just different. Are we as a society getting what we wanted or just getting what we have asked for -- more precise data? And what was free (free as a smile) is accounted and billed for.
iClickCare enables healthcare collaboration by combining words and images with discussion.