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Emergency department billing

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https://www.readbyqxmd.com/read/29768698/financial-viability-of-emergency-department-observation-unit-billing-models
#1
Christopher W Baugh, Pawan Suri, Christopher G Caspers, Michael A Granovsky, Keith Neal, Michael A Ross
BACKGROUND: Outpatients receive observation services to determine the need for inpatient admission. These services are usually provided without the use of condition-specific protocols and in an unstructured manner, scattered throughout a hospital in areas typically designated for inpatient care. Emergency department observation units (EDOUs) use protocolized care to offer an efficient alternative with shorter lengths of stay, lower costs and higher patient satisfaction. EDOU growth is limited by existing policy barriers that prevent a "two-service" model of separate professional billing for both emergency and observation services...
May 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29750945/ocular-injury-in-united-states-emergency-departments-seasonality-and-annual-trends-estimated-from-a-nationally-representative-dataset
#2
David A Ramirez, Travis C Porco, Thomas M Lietman, Jeremy D Keenan
PURPOSE: To determine whether ocular trauma occurs more frequently in the summer months. DESIGN: Retrospective, cross-sectional study. METHODS: The Nationwide Emergency Department Sample (NEDS) is a large, publicly available administrative database that provides nationally representative estimates of emergency department (ED) visits in the United States. Billing codes from NEDS from 2006 to 2013 were used to identify all cases of ocular trauma, and the United States decennial census was used to estimate the population at risk for visiting an ED...
May 8, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29728284/emergency-department-visits-for-work-related-injuries
#3
Allison Tadros, Melinda Sharon, Nicholas Chill, Shane Dragan, Jeremy Rowell, Shelley Hoffman
BACKGROUND: Work-related injuries are commonly seen in the emergency department (ED). This study sought to analyze characteristics of ED patient visits that were billed under workers' compensation. METHODS: This was a retrospective chart review of visits during 2015 that were billed under workers' compensation at an academic ED. The following variables were collected: age, gender, mechanism of injury/exposure, diagnoses, imaging performed, specialty consultation, operative requirement, follow-up specialty, and ED disposition...
April 25, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29716600/validating-an-algorithm-to-identify-metastatic-gastric-cancer-in-the-absence-of-routinely-collected-tnm-staging-data
#4
Alyson L Mahar, Yunni Jeong, Brandon Zagorski, Natalie Coburn
BACKGROUND: Accurate TNM stage information is essential for cancer health services research, but is often impractical and expensive to collect at the population-level. We evaluated algorithms using administrative healthcare data to identify patients with metastatic gastric cancer. METHODS: A population-based cohort of gastric cancer patients diagnosed between 2005 and 2007 identified from the Ontario Cancer Registry were linked to routinely collected healthcare data...
May 2, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29701587/finding-our-way-to-serving-the-underserved
#5
Zachary Hafner
It's a must because there is a cost to keeping the underserved that way whether that means funding integrated primary care to help people live healthier lives or footing the bill when people get care in the emergency department.
April 2018: Managed Care
https://www.readbyqxmd.com/read/29698347/trends-in-imaging-findings-interventions-and-outcomes-among-children-with-isolated-head-trauma
#6
Eric R Coon, Thomas B Newman, Matt Hall, Jacob Wilkes, Susan L Bratton, Alan R Schroeder
OBJECTIVE: The aim was to analyze the impact of decreased head computed tomography (CT) imaging on detection of abnormalities and outcomes for children with isolated head trauma. METHODS: The study involves a multicenter retrospective cohort of patients younger than 19 years presenting for isolated head trauma to emergency departments in the Pediatric Health Information System database from 2003 to 2015. Patients directly admitted or transferred to another facility and those with a discharge diagnosis code for child maltreatment were excluded...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29672398/evaluating-quality-metrics-and-cost-after-discharge-a-population-based-cohort-study-of-value-in-health-care-following-elective-major-vascular-surgery
#7
Charles de Mestral, Konrad Salata, Mohamad A Hussain, Ahmed Kayssi, Mohammed Al-Omran, Graham Roche-Nagle
BACKGROUND: Early readmission to hospital after surgery is an omnipresent quality metric across surgical fields. We sought to understand the relative importance of hospital readmission among all health services received after hospital discharge. OBJECTIVE: The aim of this study was to characterize 30-day postdischarge cost and risk of an emergency department (ED) visit, readmission, or death after hospitalization for elective major vascular surgery. METHODS: This is a population-based retrospective cohort study of patients who underwent elective major vascular surgery - carotid endarterectomy, EVAR, open AAA repair, bypass for lower extremity peripheral arterial disease - in Ontario, Canada, between 2004 and 2015...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29629922/medicaid-managed-care-in-florida-and-racial-and-ethnic-disparities-in-preventable-emergency-department-visits
#8
Tianyan Hu, Karoline Mortensen, Jie Chen
BACKGROUND: In an effort to address health care spending growth, coordinate care, and improve access to primary care in the Medicaid program, Florida implemented the Statewide Mandatory Managed Care (SMMC) program in May of 2014. OBJECTIVES: The objective of this study is to investigate the impact of implementation of mandatory managed care in Medicaid on the preventable emergency department (ED) utilizations, with a focus on racial/ethnic minorities. RESEARCH DESIGN: The primary data source is the universe of Florida ED visit and inpatient discharge data from 2010 to 2015, maintained by the Florida Agency for Health Care Administration...
April 7, 2018: Medical Care
https://www.readbyqxmd.com/read/29617518/prevalence-and-correlates-of-skin-cancer-screening-among-indoor-tanners-and-nontanners
#9
Carolyn J Heckman, Elizabeth Handorf, Melissa V Auerbach
Importance: The US Food and Drug Administration recommends that indoor tanners (ITs) be screened regularly for skin cancer (SC). Objective: To investigate the association between indoor tanning and SC screening. Design, Setting, and Participants: The 2015 National Health Interview Survey was a multistage, clustered, cross-sectional design with 30 352 US adults participating. The response rate for the sample adult data used in this study was 55...
April 4, 2018: JAMA Dermatology
https://www.readbyqxmd.com/read/29587713/identifying-complications-requiring-re-operation-following-primary-hip-or-knee-arthroplasty-a-consecutive-series-of-98-patients
#10
Bill Reynolds, Nick Maister, Stephen D Gill, Shaun Waring, Peter Schoch, Sally Beattie, Andrew Thomson, Richard S Page
BACKGROUND: The number of hip and knee arthroplasties completed is expected to double over the next decade. In public hospitals, regular post-arthroplasty orthopaedic review has commonly occurred for the duration of a patient's life, which requires substantial outpatient resources. However, there is limited evidence regarding the utility of these reviews for identifying complications. The current study investigated when and where complications requiring re-operation were identified following primary hip or knee arthroplasty...
March 27, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29548521/the-utility-of-the-triage-electrocardiogram-for-the-detection-of-st-segment-elevation-myocardial-infarction
#11
Samantha Noll, Heidi Alvey, Namita Jayaprakash, Aniruddha Paranjpe, Joseph Miller, Michele L Moyer, Richard Nowak
INTRODUCTION: Current AHA/ACC guidelines on the management of ST-elevation myocardial infarction (STEMI) suggest that an ECG is indicated within 10minutes of arrival for patients arriving to the Emergency Department (ED) with symptoms concerning for STEMI. In response, there has been a creep towards performing ECGs more frequently in triage. The objectives of this study were to quantify the number of triage ECGs performed at our institution, assess the proportion of ECGs performed within current hospital guidelines, and evaluate the rate of STEMI detection in triage ECGs...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29543941/utilization-of-ophthalmologist-consultation-for-emergency-care-at-a-university-hospital
#12
Sophia Y Wang, Mariam S Hamid, David C Musch, Maria A Woodward
Importance: Nearly 2 million patients visit emergency departments (EDs) because of eye concerns annually in the United States. How hospitals currently assign these patients to treatment is important for designing systems that equitably allocate resources for eye care in urgent settings. Objective: To investigate factors associated with ophthalmology consultation for eye-related adult ED encounters to assess possible disparities by sex, race/ethnicity, language preference, or residential distance from the medical center...
March 15, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29518069/vital-signs-trends-in-emergency-department-visits-for-suspected-opioid-overdoses-united-states-july-2016-september-2017
#13
Alana M Vivolo-Kantor, Puja Seth, R Matthew Gladden, Christine L Mattson, Grant T Baldwin, Aaron Kite-Powell, Michael A Coletta
INTRODUCTION: From 2015 to 2016, opioid overdose deaths increased 27.7%, indicating a worsening of the opioid overdose epidemic and highlighting the importance of rapid data collection, analysis, and dissemination. METHODS: Emergency department (ED) syndromic and hospital billing data on opioid-involved overdoses during July 2016-September 2017 were examined. Temporal trends in opioid overdoses from 52 jurisdictions in 45 states were analyzed at the regional level and by demographic characteristics...
March 9, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29466590/administrative-costs-associated-with-physician-billing-and-insurance-related-activities-at-an-academic-health-care-system
#14
Phillip Tseng, Robert S Kaplan, Barak D Richman, Mahek A Shah, Kevin A Schulman
Importance: Administrative costs in the US health care system are an important component of total health care spending, and a substantial proportion of these costs are attributable to billing and insurance-related activities. Objective: To examine and estimate the administrative costs associated with physician billing activities in a large academic health care system with a certified electronic health record system. Design, Setting, and Participants: This study used time-driven activity-based costing...
February 20, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29465644/state-laws-related-to-billing-third-parties-for-healthcare-services-at-public-std-clinics-in-the-united-states
#15
Ryan Cramer, Penny S Loosier, Andee Krasner, Jennifer Kawatu
BACKGROUND: Health departments (HDs) cite state laws as barriers to billing third parties for sexually transmitted disease (STD) services, but the association between legal/policy barriers and third party HD billing has not been examined. This study investigates the relationship between laws that may limit HDs' ability to bill, clinic perceptions of billing barriers, and billing practices. METHODS: Two surveys (1) clinic managers [N=246], 2) STD program managers [N=63]) conducted via a multi-regional needs assessment of federally funded HD clinics' capacity to bill for STD services, billing/reimbursement practices, and perceived barriers were combined with an analysis of state laws regarding third party billing for STD services...
February 7, 2018: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/29406371/pediatric-specialty-care-model-for-management-of-chronic-respiratory-failure-cost-and-savings-implications-and-misalignment-with-payment-models
#16
Robert J Graham, Michael L McManus, Angie Mae Rodday, Ruth Ann Weidner, Susan K Parsons
OBJECTIVE: To describe program design, costs, and savings implications of a critical care-based care coordination model for medically complex children with chronic respiratory failure. DESIGN: All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data...
February 3, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29398391/origins-of-the-current-outbreak-of-multidrug-resistant-malaria-in-southeast-asia-a-retrospective-genetic-study
#17
Roberto Amato, Richard D Pearson, Jacob Almagro-Garcia, Chanaki Amaratunga, Pharath Lim, Seila Suon, Sokunthea Sreng, Eleanor Drury, Jim Stalker, Olivo Miotto, Rick M Fairhurst, Dominic P Kwiatkowski
BACKGROUND: Antimalarial resistance is rapidly spreading across parts of southeast Asia where dihydroartemisinin-piperaquine is used as first-line treatment for Plasmodium falciparum malaria. The first published reports about resistance to antimalarial drugs came from western Cambodia in 2013. Here, we analyse genetic changes in the P falciparum population of western Cambodia in the 6 years before those reports. METHODS: We analysed genome sequence data on 1492 P falciparum samples from 11 locations across southeast Asia, including 464 samples collected in western Cambodia between 2007 and 2013...
March 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29382680/are-trends-in-billing-for-high-intensity-emergency-care-explained-by-changes-in-services-provided-in-the-emergency-department-an-observational-study-among-us-medicare-beneficiaries
#18
Laura G Burke, Robert C Wild, E John Orav, Renee Y Hsia
OBJECTIVE: There has been concern that an increase in billing for high-intensity emergency care is due to changes in coding practices facilitated by electronic health records. We sought to characterise the trends in billing for high-intensity emergency care among Medicare beneficiaries and to examine the degree to which trends in high-intensity billing are explained by changes in patient characteristics and services provided in the emergency department (ED). DESIGN, SETTING AND PARTICIPANTS: Observational study using traditional Medicare claims to identify ED visits at non-federal acute care hospitals for elderly beneficiaries in 2006, 2009 and 2012...
January 30, 2018: BMJ Open
https://www.readbyqxmd.com/read/29336769/processes-of-health-care-delivery-education-and-provider-satisfaction-in-acute-care-surgery-a-systematic-review
#19
REVIEW
Kristin DeGirolamo, Patrick B Murphy, Karan D'Souza, Jacques X Zhang, Neil Parry, Elliott Haut, W Robert Leeper, Ken Leslie, Kelly N Vogt, S Morad Hameed
In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29275460/implementation-of-a-regional-perinatal-data-repository-from-clinical-and-billing-records
#20
Eric S Hall, James M Greenberg, Louis J Muglia, Parth Divekar, Janet Zahner, Jay Gholap, Matt Leonard, Keith Marsolo
Objectives To describe the implementation of the first phase of a regional perinatal data repository and to provide a roadmap for others to navigate technical, privacy, and data governance concerns in implementing similar resources. Methods Our implementation integrated regional physician billing records with maternal and infant electronic health records from an academic delivery hospital. These records, representing births during 2013-2015, constituted a data core supporting linkage to additional ancillary data sets...
April 2018: Maternal and Child Health Journal
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