Clinical integration of billing for a pediatric nephrology and transplant program.
OBJECTIVE
To develop and implement a billing process that fully integrates all activities of a pediatric nephrology and transplant program, by facilitating and coordinating data from patients, physicians, hospitals, and third-party billing services to maximize revenues.


METHODS
Financial operations were analyzed via a randomized audit of patient charts that focused on office procedures and revenue collection. Results based on monthly reports documenting revenue received and outstanding, procedures billed, and patient registration accuracy.


RESULTS
The combination of improvements in patient registration, chart documentation, new billing sheets with procedure and diagnosis codes, physician in-service education, upgraded charges, and the recredentialing of all practice physicians realized an increase in revenue collections from 18% in 2000 to 89% in 2001.


CONCLUSIONS
The need to integrate and coordinate information is vital for both billing accuracy and revenue collections. Integration of clinical services and billing procedures has maximized performance, profitability, and accuracy while decreasing administrative time and costs.
Tietjen
Andrea L
AL
Saint Barnabas Medical Center, Livingston, NJ, USA.
Orsini
Jenoveva
J
Mulgaonkar
Shamkant
S
Morgan
Debbie
D
D002648:Child; D003362:Cost-Benefit Analysis; D004282:Documentation / Q000592:standards; D017598:Efficiency, Organizational; D005251:Fees, Medical / Q000706:statistics & numerical data; D005375:Financial Audit; D005377:Financial Management, Hospital / Q000379:methods*; D005568:Forms and Records Control; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007344:Insurance Claim Reporting; D007349:Insurance, Health, Reimbursement; D016030:Kidney Transplantation / Q000191:economics*; D008499:Medical Records / Q000592:standards; D009398:Nephrology / Q000191:economics*; D009515:New Jersey; D010350:Patient Credit and Collection; D010372:Pediatrics / Q000191:economics*; D018511:Systems Integration; D013997:Time Factors