The importance of accurate documentation for financial recovery
Episode 5
Dr. Lucian Newman III is a General Surgeon and the Chief Medical Information Officer for Nuance. He shares why coding with detail and accuracy, especially when it comes to comorbidities, is crucial for attracting new patients.
Episode summary
Financial recovery
Dr. Newman highlights that viruses have been impacting our lives for forever, but the difference with COVID-19 is how quickly it has hit. And while physicians have always known that patients with comorbidities are more vulnerable to these viruses, this is becoming increasingly more important to be able to document for billing and care documentation purposes.
2:49 “It’s never been the practice of doctors per say to really focus on proving the sickness or health of the patient, but that is something that all of the insurance companies are interested in, that all the hospitals are interested in, because we live in an increasingly analytic world.”
These analytics that describe your patients become public record, and can be viewed on Healthgrades, Hospital Compare, Angie’s List, or the State Department of Health site. This is important, because potential patients who are looking for the care you provide will review these records and compare them to other providers in an effort to choose the best quality care. Even if you provide excellent care, if you do not do a good job coding your work, this excellence will not be reflected in your public record. This impacts your business, because you will not attract the patients that are searching for high-quality care.
Detail matters
Dr. Newman notes that the detail required for coding can be as subtle as making sure that your appendectomy surgery patient’s comorbidity of “uncontrolled diabetes” is coded as such, and not just “diabetes.” With uncontrolled diabetes, they may have to stay for a few days post surgery to recover in order to get their blood sugar under control. But if you don’t code for that specific comorbidity, these extra days post surgery look like a direct result of the quality of the surgery itself, instead of underlying conditions.
6:40 “Some of this is intuitive to most physicians, but the problem is that as a General Surgeon on an Orthopedic Surgeon, you’re not treating diabetes. And I’m not suggesting that they should treat the diabetes, I’m suggesting that they should make sure that their work acknowledges that that’s being treated. And…we don’t really receive training in medical school or residency on coding.”
This is why every surgeon should invest in tools that make them better coders, especially as our world and business models become increasingly driven by data. Dr. Newman encourages physicians to support their practice with these resources so that they are capturing their care accurately, for both their patients’ health and financial reimbursement.