As we got further into lower reimbursements, insurance companies and the federal government created more hoops for us to jump through to get paid for services. Denials came from diagnostic errors, procedure code incompatibility, unbundling and inclusive denials, Dworshak says, noting that West Florida Medical officials had begun tracking the denial rate as early as 1998, in the days when most reimbursements flowed more freely than today. Income due but not received was bad enough. But it was the correction process itself that steadily depleted the medical center s resources. We wanted to move the entire process back to the point of service, Dworshak says, back to the point of the physician or nurse who was making the decision about codes and who would know, as those charges were entered at the point of service, whether or not those services were likely to be paid.
Big bang happens at the point of service.
Dovetailing Advances Making error corrections on your AR is a nightmare to deal with. You want to make as few corrections as possible to keep your AR as clean as possible, she says. We had the vision in 1998 to move the decision-making process back to the point of service, to the physician s office where that charge originates. It was one of the few that could take charges at the point of service, transaction by transaction, online and in a paperless process while also determining, on the front end, whether the charges would be paid. Choosing ADP Context s CEP product was a risk for West Florida Medical since the company was relatively new.