Billing capture: the cure is at hand

What appears to be the first scientific study to evaluate the use of handheld computers for charge capture gave the technology high marks. Results of the study, presented Sunday at the HIMSS meeting, are important because of the increased need for accuracy in medical billing to avoid government fines involving Medicare and Medicaid fraud.

New billing solutions are also financially relevant, since hospitals and physicians lose an estimated $60 billion annually due to lost or miscoded charges.

The average physician loses about $60,000 a year for the same reasons, according to the paper's author, Dr. Scott M. Strayer, an assistant professor of clinical family medicine at St. Louis University who is also president and CEO of PocketMed, a maker of handheld software solutions.

Handheld computers offer one obvious opportunity to improve clinical billing practices. Around 20% of physicians already use handheld computers to enhance the delivery of medical care, according to The New York Times. An analysis by W.R. Hambrecht predicted that by next year more than 50% of all physicians will have incorporated the technology in their practices.

Currently, physicians capture inpatient codes using index cards and preprinted charge slips.

Strayer compared the billing accuracy of six physicians at St. Louis University Family Practice Residency during two three-month periods before and after implementation of a handheld charge capture system. The study found that five out of six attending physicians used the handheld computer billing method for a compliance rate of 83%. Charge capture rates were calculated for these five faculty members.

When the index cards were used, 86 patients were recorded compared with 105 patients recorded using the hospital system, representing a charge capture rate of 82%.

After implementation of the billing system, 113 of 122 patients were captured, representing a 93% charge capture rate, a statistically significant increase in patient capture.

"The number of inpatients captured increased, and the technology was easily implemented and acceptable to the majority of study physicians with minimal (one-hour) training," Strayer said.