A single-center experience in capturing inpatient evaluation and management for an IR practice.
OBJECTIVE
To demonstrate that interventional radiologists can capture work relative value units (wRVUs) for the work that is already being performed providing evaluation and management (E&M) clinical services.


METHODS
A team approach was implemented to optimize revenue capture for inpatient E&M. Structured templates were created for inpatient documentation to ensure that maximum wRVUs were captured. Inpatient billing was audited from fiscal year 2011 (1 year before meeting and structured template creation) through fiscal year 2014. Specifically, data were collected on total charges, collections, wRVUs and total number of inpatient E&M encounters, and the level of the billed encounter.


RESULTS
Retrospective annual audits revealed that overall inpatient E&M billing charges increased by 722%, whereas collections increased by 831% from 2011 to 2014. The wRVUs increased in 2011 from 181.74 to 1,396.9 (669% increase) in 2014, and the number of inpatient E&M encounters billed increased from 130 to 693 (433% increase) over that same time period. Lower level billing (level I) declined from 30% to 19%, and complex billing levels (level II or higher) increased from 70% to 81%.


CONCLUSIONS
By implementing a systems approach to revenue management, which includes physician and billing staff meetings and the use of structured templates, billing capture from inpatient E&M services can be improved.
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226.. Electronic address: sbwhite@mcw.edu.
Sarah B
SB
White
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226.
Stephanie L
SL
Dybul
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226.
Parag J
PJ
Patel
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226.
Eric J
EJ
Hohenwalter
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226.
Robert A
RA
Hieb
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226.
Samir P
SP
Shah
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226.
William S
WS
Rilling
Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226.
Sean M
SM
Tutton
D039702:Current Procedural Terminology; D017598:Efficiency, Organizational; D005249:Fees and Charges; D017722:Hospital Charges; D017721:Hospital Costs; D006801:Humans; D007297:Inpatients; D017146:Models, Organizational; D011216:Practice Management, Medical / Q000191:economics / Q000458:organization & administration; D015641:Radiography, Interventional / Q000191:economics; D012017:Referral and Consultation; D015895:Relative Value Scales; D012189:Retrospective Studies; D013997:Time Factors; D014922:Wisconsin