A systematic review of outpatient billing practices
Objectives: Healthcare coding and billing are an important aspect of practice management that directly impacts the financial stability of a health care practice. To financially sustain or grow a medical practice, it is imperative that resident and faculty physicians have knowledge and skills for acc...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-05-01
|
| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121221099021 |
| _version_ | 1811255702331588608 |
|---|---|
| author | Kristie Burks Jessie Shields Joseph Evans Jodi Plumley Jarrett Gerlach Susan Flesher |
| author_facet | Kristie Burks Jessie Shields Joseph Evans Jodi Plumley Jarrett Gerlach Susan Flesher |
| author_sort | Kristie Burks |
| collection | DOAJ |
| description | Objectives: Healthcare coding and billing are an important aspect of practice management that directly impacts the financial stability of a health care practice. To financially sustain or grow a medical practice, it is imperative that resident and faculty physicians have knowledge and skills for accurate billing in every patient encounter. Methods: A systematic review was conducted to identify recently published studies that report on improvements in medical coding and billing accuracy, clinical documentation, and reimbursement rate. A search of three databases yielded a total of 5754 records. After screening, 41 records were sought for retrieval and a total of 18 records were obtained for review. Results: Following a thorough review of literature, the most common reasons for inaccurate or inappropriate billing were a lack of formal education within residency curriculum, inadequate clinical documentation supporting level of billing, and lack of a feedback system aimed to correct billing errors. Conclusion: A formal education curriculum implemented in training could enhance knowledge and application of accurate billing and coding and further benefit practice longevity. The purpose of this systematic review is to apply knowledge gained to the development and implementation of a quality improvement study intended to improve accuracy of coding and billing within an academic pediatric outpatient center. |
| first_indexed | 2024-04-12T17:28:52Z |
| format | Article |
| id | doaj.art-1302a6f1c4014a9d811c8d6121611fd3 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-04-12T17:28:52Z |
| publishDate | 2022-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-1302a6f1c4014a9d811c8d6121611fd32022-12-22T03:23:12ZengSAGE PublishingSAGE Open Medicine2050-31212022-05-011010.1177/20503121221099021A systematic review of outpatient billing practicesKristie BurksJessie ShieldsJoseph EvansJodi PlumleyJarrett GerlachSusan FlesherObjectives: Healthcare coding and billing are an important aspect of practice management that directly impacts the financial stability of a health care practice. To financially sustain or grow a medical practice, it is imperative that resident and faculty physicians have knowledge and skills for accurate billing in every patient encounter. Methods: A systematic review was conducted to identify recently published studies that report on improvements in medical coding and billing accuracy, clinical documentation, and reimbursement rate. A search of three databases yielded a total of 5754 records. After screening, 41 records were sought for retrieval and a total of 18 records were obtained for review. Results: Following a thorough review of literature, the most common reasons for inaccurate or inappropriate billing were a lack of formal education within residency curriculum, inadequate clinical documentation supporting level of billing, and lack of a feedback system aimed to correct billing errors. Conclusion: A formal education curriculum implemented in training could enhance knowledge and application of accurate billing and coding and further benefit practice longevity. The purpose of this systematic review is to apply knowledge gained to the development and implementation of a quality improvement study intended to improve accuracy of coding and billing within an academic pediatric outpatient center.https://doi.org/10.1177/20503121221099021 |
| spellingShingle | Kristie Burks Jessie Shields Joseph Evans Jodi Plumley Jarrett Gerlach Susan Flesher A systematic review of outpatient billing practices SAGE Open Medicine |
| title | A systematic review of outpatient billing practices |
| title_full | A systematic review of outpatient billing practices |
| title_fullStr | A systematic review of outpatient billing practices |
| title_full_unstemmed | A systematic review of outpatient billing practices |
| title_short | A systematic review of outpatient billing practices |
| title_sort | systematic review of outpatient billing practices |
| url | https://doi.org/10.1177/20503121221099021 |
| work_keys_str_mv | AT kristieburks asystematicreviewofoutpatientbillingpractices AT jessieshields asystematicreviewofoutpatientbillingpractices AT josephevans asystematicreviewofoutpatientbillingpractices AT jodiplumley asystematicreviewofoutpatientbillingpractices AT jarrettgerlach asystematicreviewofoutpatientbillingpractices AT susanflesher asystematicreviewofoutpatientbillingpractices AT kristieburks systematicreviewofoutpatientbillingpractices AT jessieshields systematicreviewofoutpatientbillingpractices AT josephevans systematicreviewofoutpatientbillingpractices AT jodiplumley systematicreviewofoutpatientbillingpractices AT jarrettgerlach systematicreviewofoutpatientbillingpractices AT susanflesher systematicreviewofoutpatientbillingpractices |