October 1, 2013 | Net Health

3 Minute Read

Practice Point: Processes + Workflows Drive Documentation Compliance

Process and Workflow Drivers

In order to achieve accurate documentation and payment for wound care, you must invest time to create best practices for your processes and workflows. Process is the thread that pulls documentation and payment together. Workflow analyzes your department’s key processes and determines the proper steps to eliminate redundancies by identifying gaps in your practice, all in an effort to provide optimization (Figure 1).

Revenue Cycle Management and Medical Necessity Drivers

Revenue cycle processes include patient registration, compliant billing, and denial management for a fiscally successful department. These processes are governed by policy. Policies specify the circumstances under which payers cover specific services. Furthermore, most payers have implemented medical necessity guidelines for wound care services.

Chargemaster and Billing Drivers

The wound care department’s charge description master represents chargeable services and will include CPT-4 and Healthcare Common Procedure Coding System (HCPCS) Level II codes1 that define the services conducted and/or used during the visit…


Read the rest of the article at Advances in Skin & Wound Care.

An excerpt from an article originally published in Advances in Skin & Wound Care, written by Cathy Thomas Hess, BSN, RN, CWOCN, VP and Chief Clinical Officer at Net Health

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