title: Implementation of a novel point-of-care ultrasound billing and reimbursement program: fiscal impact.
abstract: OBJECTIVE
  The aim of this study was to determine the fiscal impact of implementation of a novel emergency department (ED) point-of-care (POC) ultrasound billing and reimbursement program.
  
  
  METHODS
  This was a single-center retrospective study at an academic medical center. A novel POC ultrasound billing protocol was implemented using the Q-path Web-based image archival system. Patient care ultrasound examination reports were completed and signed electronically online by faculty using Q-path. A notification was automatically sent to ED coders from Q-path to bill the scans. ED coders billed the professional fees for scans on a daily basis and also notified hospital coders to bill for facility fees. A fiscal analysis was performed at the end of the year after implementing the new billing protocol, and a before-and-after comparison was conducted.
  
  
  RESULTS
  After implementation of the new billing program, there was a 45% increase in the ED faculty participation in billing for patient care examinations (30%-75%). The number of ultrasound examinations billed increased 5.1-fold (4449 vs 857) during the post implementation period. The total units billed increased from previous year for professional services to 4157 from 649 and facility services to 3266 from 516. During the post implementation period, the facility fees revenue increased 7-fold and professional fees revenue increased 6.34-fold. After deducting the capital costs and ongoing operational costs from approximate collections, the net profits gained by our ED ultrasound program was approximately $350000.
  
  
  CONCLUSIONS
  Within 1 year of inception, our novel POC ultrasound billing and reimbursement program generated significant revenue through ultrasound billing.
authors.affiliation: Department of Emergency Medicine, The University of Arizona Medical Center, Tucson, AZ, USA. Electronic address: sriadhikari@aol.com.
authors.forename: Srikar
authors.initials: S
authors.lastname: Adhikari
authors.affiliation: Department of Emergency Medicine, The University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Amini
authors.affiliation: Department of Emergency Medicine, The University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Lori
authors.initials: L
authors.lastname: Stolz
authors.affiliation: Department of Emergency Medicine, The University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: O'Brien
authors.affiliation: Department of Emergency Medicine, The University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Austin
authors.initials: A
authors.lastname: Gross
authors.affiliation: Department of Emergency Medicine, The University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Travis
authors.initials: T
authors.lastname: Jones
authors.affiliation: Department of Emergency Medicine, The University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Fiorello
authors.affiliation: Department of Emergency Medicine, The University of Arizona Medical Center, Tucson, AZ, USA.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Keim
mesh_terms: D000046:Academic Medical Centers / Q000191:economics / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000191:economics* / Q000458:organization & administration; D005377:Financial Management, Hospital / Q000191:economics / Q000458:organization & administration; D017722:Hospital Charges / Q000458:organization & administration; D006801:Humans; D019095:Point-of-Care Systems / Q000191:economics* / Q000458:organization & administration; D012051:Reimbursement Mechanisms / Q000191:economics / Q000458:organization & administration*; D012189:Retrospective Studies; D014463:Ultrasonography / Q000191:economics*