Healthcare billing in the United States involves a rigorously complex chain of events. It requires cooperation between a range of individuals and departments. This inherently means that there’s a high margin for error. Moreover, healthcare billing standards remain in constant flux due to an imbalanced political climate. As it stands, if either Medicare or Medicaid notices that one or several physicians have been improperly billing patients or insurance companies, the entire facility for which the physicians work runs the risk of falling victim to potentially detrimental audits, clawbacks and legal action. What starts as a careless mistake often metastasizes into a series of inappropriate measurements and indicators. And this can lead to poor patient satisfaction and reduced revenues.
How Doctors Can Inadvertently Bankrupt Their Employers
During patient examination, a physician must determine the nature and severity of the patient’s visit. The doctor must determine how many of the patient’s systems he or she should check. He or she must base this decision on a series of variables, namely the patient’s medical history, how many visits he or she has had in the past year, and whether he or she is showing any signs of distress in particular regions of the body. How many systems that the doctor examines determines what’s called a level. And it’s this level that determines how much the hospital can bill the patient. Then the billing department sends this bill to an insurance company.
The problem is that the level selection process is tremendously complex. Physicians frequently misjudge how many systems they should check. As a result, they can sometimes spend an inappropriate amount of time on each patient. If a physician makes an incorrect judgment when selecting a patient’s level, he or she may end up spending too much time with the patient, thus charging an insurance company an inaccurate amount of money. This, in turn, can lead to poor patient satisfaction and sometimes more severe consequences.
How Hiteks Plans To Protect Hospitals From Their Employees
With the Hiteks’ VigilantQA Software, we aim to vanquish that margin of error. We want to protect physicians from themselves, and thus protect the hospitals that employ them. Our plan is to do so by eliminating the possibility of improper diagnosis and/or inaccurate level selection. We believe that doctors should have real-time reminders and support that’s consistent with the billing system criteria. We also believe that each and every patient should get the time and attention that he or she deserves. With our VigilantQA Surveillance for Sepsis and other Patient Safety Indicators, equipped with automated diagnosis improvement and CDI software, doctors will know precisely how much time they should be spending with each patient and what to focus on.
Hiteks’ software comes in three packages, which we distribute all throughout the nation. To learn more about our products, give our office a call today at 212-920-0929.