Reducing trauma payment denials with computerized collaborative billing.
BACKGROUND
Trauma care demands constant physician availability, resulting in rotational coverage systems. Third-party payors consider separate trauma surgeon bills as originating from the same individual. Trauma surgeons may be unaware of their colleagues' billing history on jointly managed patients. Not all postoperative procedures and evaluation and management services are denied by global surgical package rules. We investigated whether a networked billing program designed to crosscheck for global package coding concerns would reduce payment denials.


METHODS
A networked relational database was created for trauma surgeons to enter billable encounters, displaying global periods and operative diagnoses while prompting for postoperative modifiers. Denials were compared for equivalent time periods before and after program initiation.


RESULTS
Payment denials fell from 361 to 16 for "bundled" evaluation and management services and from 55 to 13 for bundled postoperative procedures. Time spent on billing decreased and legibility improved. Overall savings totaled $183,404.


CONCLUSIONS
Collaborative billing can improve payments for professional trauma care.
Reed
R Lawrence
RL
Department of Surgery, Layola University Medical Center, Maywood, Illinois 60153, USA. rreed@lumc.edu
Davis
Kimberly A
KA
Silver
Geoffrey M
GM
Esposito
Thomas J
TJ
Tsitlik
Victoria
V
O'Hern
Timothy
T
Gamelli
Richard L
RL
D005568:Forms and Records Control; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D016347:Medical Records Systems, Computerized; D011216:Practice Management, Medical / Q000191:economics*; D012984:Software; D014194:Traumatology / Q000191:economics*