SHM Converge Scientific Abstract ePoster Gallery-Hospitalists Led Education Improves Department Billing and Coding

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A pilot project at one institution tested whether hospitalist-led peer education using provider-specific billing data could improve billing and coding accuracy in internal medicine hospitalists. The project addressed a common gap: medical training often provides little formal instruction in documentation for billing, and both residents and attending physicians report limited confidence and a desire for more education.<br /><br />The intervention included an audit of departmental billing, comparison of de-identified provider graphs, a 90-minute education session led by trained authors, and examples from actual provider notes. Providers completed pre- and post-surveys about prior billing education, confidence, and knowledge. Targeted feedback was then provided at one- and two-month follow-up, focusing on documentation that supports billing codes.<br /><br />The project’s main goal was to increase appropriately coded hospital encounters to above 70% based on documentation. Results were positive: one month after education, 100% of reviewed documentation (20 notes) accurately matched the associated billing code. The variability in level 3 billing codes decreased, though not significantly overall. Specifically, standard deviation decreased for initial level 3 code 99223 and subsequent level 3 code 99233. Billing in the pilot group also shifted toward more level 3 codes, which was associated with an estimated $60,000 monthly revenue increase for the department. Clinical denials declined from 1.43% to 1.28%.<br /><br />Survey feedback was strongly favorable: 100% of physicians said the education was helpful, and 100% reported increased knowledge. The authors suggest expanding this type of education to the full hospitalist group, adapting it for other departments, developing curricula for internal medicine residents, and continuing audits and feedback.

Asset Subtitle

Colleen McIntosh

Meta Tag

Author List Colleen McIntosh, Jaimie L. Weber

Category Research

Concept Clinical Documentation

Concept Code Accuracy

Concept Billing

Concept Coding

Concept Documentation Quality

Distinguished Non-Finalist

Presenter Organization University of South Florida

Presenting Author Colleen McIntosh

Track Quality Improvement

Keywords

hospitalist education

billing accuracy

coding compliance

documentation quality

internal medicine

peer education

provider-specific billing data

hospital billing audit

revenue increase

clinical denials

Clinical Documentation

Code Accuracy

Billing

Coding

Documentation Quality