![]() If the occurrence rates get too high, these types of adverse events may be counted as hospital-acquired conditions and are part of the basket of measures that can drive down Medicare payments and perhaps payment under other types of value-based models, such as accountable care organizations, gainsharing, or alternative payment models. #Impact client dupelicate full#This can lead to duplicate medications prescribed, as well as potential adverse effects from dangerous drug interactions or allergies that may have been documented in one system but are missing from others.Īnother heightened risk is errors of omission, where a drug that would likely have benefitted a patient is not prescribed because the full condition of the patient is not accessible to the ordering clinician. For example, providers without access to a single, complete patient record may not know what medications their patients are taking. Incomplete information due to duplicate or partial records can contribute to clinical errors and adverse events. Effectiveness of the population health system declines, resulting in low-quality metrics and impediments to maximizing revenues.Ĭlinical quality. For example, if records in one location’s system identify a patient as diabetic, but that diagnosis is missing from another database used by the team doing outreach to patients with chronic care needs, a screening test may be missed, or diet counseling may be overlooked. Incomplete patient records can lead to providers failing to recognize at-risk patients and missing opportunities to proactively schedule screenings or treatments. Many of the metrics related to payment are process and outcomes measures that are part of care plans intended to ensure all members of a population at risk for a specific condition are getting the right care at the right time. There are numerous ways in which duplicate or incomplete patient records can undermine hospitals’ quality efforts and metrics that directly drive the payment formulas for Medicare, Medicaid, and other private payers under various value-based payment methods. When inefficient back-and-forth communications are the only method to gather fragmented billing information, there are risks to the bottom line in terms of wasted time, sluggish cash realization, and loss of expected A/R. Without complete views of patients and their billing records, it can take a significant amount of time to gather information to send to payers. Similarly, incomplete information will lead to delays because health plans must ask for more information to process claims, or claims may be denied because they are not timely. These are not only potential missed payment opportunities, but these occurrences could also affect patient satisfaction scores. When insurance information is available on one episode of care, but not appropriately attached to another for the same patient, the patient guarantor may be erroneously billed for the full balance, or an incomplete claim may be submitted to insurance. Incorrect billing results in wasted time and resources, lengthening of days in accounts receivable (A/R), and an increase in bad debt write-offs. Patient Accounting Inefficienciesĭuplicate or incomplete patient records can cause hospitals to inadvertently bill payers or patients for more than or less than the correct amount, leading to direct revenue loss. Understanding the wide-ranging impacts of this data-quality problem adds urgency to projects focused on cleaning up existing problems with duplicates and provides a financial rationale for implementing systems that minimize future problems. Duplicative and incomplete patient records have long caused problems in the traditional fee-for-service revenue cycle, and they also can undermine performance measures that drive revenues under value-based payment models. Understanding wide-ranging implications adds urgency to developing solutions.ĭuplicate patient records in your hospital or health system can have negative impacts on revenues. ![]()
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