How to Overcome Coding and Documentation Challenges as Outpatient Volume Grows
Over the past few years, the convergence of numerous trends has resulted in a steady decline of inpatient hospital services. Thanks to technological and procedural advances, a growing tendency of consumers to avoid hospitals and the transition to value-based payment models, more care is shifting to outpatient settings. Programs and incentives are requiring healthcare providers to invest heavily in this area as a result. Inpatient services and “heads in beds” used to be the primary source of revenue at many hospitals, but those days appear to be receding. According to a Deloitte Insights investigation of hospital revenue trends, inpatient revenue experienced a compound annual growth rate of 6% from 2011 to 2018, while outpatient revenue grew 50% more (or an average of 9% annually over the same period). The rapid growth in outpatient volume has blurred the lines between inpatient and outpatient departments, but certain obstacles stand in the way of effective collaboration.
Coding and Documentation Challenges In the outpatient treatment environment, the revenue cycle department increasingly relies on coding and documentation to support the claims and payment process. With large increases in patient volume and a high turnover rate, however, the accuracy of this documentation can pose a problem. Single coders are often expected to review documentation, coding, and risk at the same time, and physicians can’t return to each completed chart to answer queries because outpatient visits last an average of just eight to 40 minutes instead of possibly days in the inpatient setting.