With the ageing population on the increase and the percentage of chronic illness on the rise, wound care is of paramount importance in most hospitals. Chronic wounds include diabetic ulcers, surgical wounds that will not heal, venous, arterial, and pressure ulcers. Given that Obamacare has led to many more people coming under insurance, and the ageing population also on the increase, every outpatient wound care program needs to be very clear on its billing and coding process. It is often a challenge for most hospitals to provide clinically excellent and cost effective wound care service. It is only in the recent past that wound management has become one of the metrics assessed. This is in part due to the increased interest in wound care services by third party payers, the Centers for Medicare and Medicaid Services (CMS), and the Joint Commission.
It has been stated that more than 7 million people in the US (2 percent of the total population) experience a chronic, non-healing wound and require care. Wound care procedures have over time become complicated -the introduction of the ICD-10 coding system is one of the major factors that is often a challenge for the coders & billers. Moreover, it also forms a large percentage of reimbursement income for hospital facilities & physicians. .
Ohio State is known for its centers of advanced chronic wound care healing services. Given that Ohio focuses on the best treatment they give to patients, most Ohio physicians do not wish to be detracted from their focus. Billing and coding for wound care can be highly complex and involves documenting wound laterality, wound dimensions, debridement etc which need to be well documented. Documentation itself, both clinically and administrative can be very tedious, given the need for providing evidence in case of claim rejection or denial. Hospitals often find it difficult to provide quality wound care treatment especially on a volume basis. Treating patients with wound care involves a lot of effort and can be time consuming. Ohio wound care practitioners wish to focus on delivering the best wound care treatment to their patients given the advancement in technology that they are known to equip their centers with. Rather than focus on resources to be spent on documenting wound care treatment, and spend time on thinking how to deliver highest quality outcomes at the lowest total cost of care and simultaneously keep their patients satisfied, Ohio physicians have learnt that it is easiest to outsource the tedious wound care billing process and concentrate on dealing with their patients- their prime focus. Moreover, with the Value based performance fee also being introduced, outpatient wound care centers would find it difficult to provide quality care with limited resources and time. If physicians handling wound care services were to calculate the money being spent on wound care dressings, equipment, and service contracts, they would definitely find it far out weighing their revenue, and soon run at a loss.
Thus, Ohio wound care specialists have learnt that the right way to achieve the highest quality of outcome in treatment with highest patient satisfaction is by outsourcing their wound care billing process which in the long run equals low costs shelled out for infrastructure and processes, and the profits can be easily employed to bring in better equipment and program better treatment facilities and therapies.Back