2 Major financial impacts of missing clinical documentation

2 Major financial impacts of missing clinical documentation


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By: Terri Embry-Drummond, RN, BSBA, Vice President of Customer Success, CitusHealth

Does your organization hope to achieve growth, hire new staff, acquire other companies, or meet the expectations of stakeholders? One or more of those are likely to apply to your organization, but those who lack an efficient method of collecting cash will fail to meet all of their goals.

Talking about cash collection can be uncomfortable for some, but it’s necessary to find the gaps between providing a service and collecting the money for your organization to grow. So, what causes these gaps? It often comes down to one culprit: missing clinical documentation.

If you’re waiting on documentation to submit a claim, then your revenue is on hold. One industry challenge that leads to this is that every payor is different. You might have the same diagnosis that requires the same drug, but there are two different payors. Each payor has different requirements for claims—such as nursing notes, and orders are only good for so long until new orders are needed—which means organizations must hold revenue until those requirements are obtained.

Another reason organizations find themselves waiting on documentation is manual processes and disjointed communication. Relying on phone calls, email, fax, or having to send staff to get physical signatures can be time consuming, keeps clinicians from focusing on care, and can take sales people away from potential sales.

With the right technology, organizations can define their own journey for order forms that can easily track and notify when signatures are needed. Clinical documentation is completed instantly, claims can be submitted in a timely manner, and cash can get collected faster.

Simply put, the less you’re waiting on required paperwork and the more accurate that documentation is, the less revenue you have on hold. Here are two major financial impacts of missing clinical documentation—and how they can be avoided.

Deductions caused by payor audits
Right when you think you’re on budget for the year, you get a $200,000 deduction from your top-line revenue due to a payor audit that discovered unsigned orders. These audits look for any piece of the puzzle that gives them the right to get their money back, including something as simple as nursing notes or forgotten consent forms.

Technology that gives you and your patients seamless communication makes documentation more thorough and accurate, and gives clinicians more time to focus on providing better care.

Failure to keep patients on service
Your organization works hard to get referral sources and patients, so providing quality care is important to avoid interruption. When patients are not properly educated on their medication, potential side effects, or other elements of their care, they could end up in the hospital, where their care could be completed or they could be referred to another organization.

Clinical documentation can help prevent these care interruptions. But when clinical staff is spending time playing phone tag, listening to voicemails, and replying to an overflowed inbox of emails, they can miss opportunities to intervene. The right technology can help elevate the unnecessary human touch factor, because less time is being spent on calls, paperwork, and other administrative tasks.

When operations are efficient, your business can grow.
Consider landing a contract for all your referral partner’s business. That’s great news. But if you don’t have operations efficient enough to collect the amount of cash vital to meeting that contract’s need, then you won’t have it for very long.

You need to provide great care, document thoroughly and accurately, and collect cash so you can continue paying your staff, and ultimately continue providing great care. With CitusHealth, your organization gets seamless communication and an app-less solution for forms and documents. The automated education management allows for all the touch points to be in one platform.

We’d love to show you how CitusHealth can make your operations more efficient, so you can focus on better care and growing your business.

Schedule a demo with us today.

Terri Embry-Drummond, RN, BSBA
Terri Embry-Drummond, RN, BSBA
Vice President of Customer Success, CitusHealth

A registered nurse with a bachelor’s degree in business and marketing, Terri’s career has spanned almost three decades in regional and national home, specialty and long-term care infusion operations, sales, and informatics leadership. Her experience with cutting-edge workflow optimization has allowed her to understand the challenges both customers and their patients face. With CitusHealth, she leads the adoption and retention team helping to bring the voice of customers to the product development roadmap.

Terri has been in leadership, sales, and nursing roles for companies such as BioScrip, Omnicare, and Olsten-Kimberly Quality Care.