June 1999 Bulletin

Palm PC's can help coding

Can be used to capture hospital visits, procedures

By Rosemarie Nelson

The palmtop PC's and handheld PC's are capturing the interest of mobile professionals. These small devices are easy to slip into a jacket pocket and provide access to calendars, phone numbers, e-mail, and of course the web. Everyone has at one time or another been in a meeting or seen a physician pull a small plastic case or device out of their pocket to check a date or look up a phone number or address. But these devices can do even more to improve the efficiency of your medical practice operations.

A significant billing problem is often the capture of hospital visit charges as well as specific surgical procedures to be billed. The first hard step is simply getting the information from the physician. Physicians have little scraps of paper and notes or cards, listing who they saw and there may be a several day delay from the time the physician sees the patient until the physician relays that information to the billing staff. That is a delay in cash collections.

And when these tidbits get to the billing staff, the interpretation begins. It is often difficult to decipher the patient information as well as to determine the appropriate CPT code and level of service to bill. When performing surgery with multiple procedures in one session, the capture of all the procedures is essential for appropriate reimbursement from the third party payers. And of course, if your physician visits multiple hospitals, it may be an additional investigative task for the billing staff to figure out in which hospital the patient was seen.

It is likely that one or more of the physicians in your practice have a handheld device that they may be using now to store contact names and phone numbers. So with no additional expense, you can probably create a form or document on that handheld or palmtop PC that lets the physician easily track the patients she/he has seen in the hospital each day, noting services provided and at which hospital service was provided.

If the physician is in the market to purchase a handheld or palmtop, the offerings are abundant. Technology purchases are more satisfying if the approach is made with a prioritized list of the user's needs. Weekly and monthly PC magazines as well as various web sites provide the latest reviews of these devices with pricing info as well. The models vary from simple palmtop units with a stylus pen for navigation to miniature handheld PC's that includes a keyboard for brief data entry. And, of course, the prices can vary as well from under $200 to $1,000. Almost all these devices also provide for connectivity to the Internet, which can allow the roaming physician access to electronic mail and web searches.

A physician in a hospital setting, an emergency room, a satellite clinic or office, or even in their own primary office setting can use the handheld to capture all types of billable services. When the physician returns to the office, he/she simply attaches to a desktop PC and transfers that file to the desktop. If the office has a local area network installed, the files can be easily shared among physicians and support staff, so no additional steps are required of the physician. Even without a network, the physician can simply print the downloaded file, and the billing staff now have a neat, full size piece of paper as a source document from which to bill.

Rosemarie Nelson is a health care information technology consultant in Syracuse, N.Y.

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