Murray B P, Dwore R B, Parsons R J, Smith P M, Vorderer L H
Utah Hospital Association, Salt Lake City.
Healthc Financ Manage. 1994 Mar;48(3):52-4, 56, 58-60.
Rural hospitals have been failing over the last two decades, and one of the biggest reasons has been lack of attention paid to detail and accuracy in the coding and pricing of services rendered. Most research that has explored the problems of coding accuracy and its impact on reimbursement has focused on coding by medical record professionals, but many coding procedures are performed by "front line" lower-level employees working in a hospital's laboratory, radiology department, pharmacy, or other ancillary service departments. This article explains how rural hospitals can optimize their reimbursement and adhere to Medicare/Medicaid and other third-party payer regulations by training coders properly and by reviewing their pricing policies to make sure that prices charged accurately reflect the true cost of services.
在过去二十年里，乡村医院一直在衰败，其中一个最大的原因是在提供服务的编码和定价方面缺乏对细节和准确性的关注。大多数探讨编码准确性问题及其对报销影响的研究都集中在病历专业人员的编码上，但许多编码程序是由医院实验室、放射科、药房或其他辅助服务部门的“一线”基层员工执行的。本文解释了乡村医院如何通过正确培训编码人员并审查其定价政策，以确保所收取的价格准确反映服务的真实成本，从而优化报销并遵守医疗保险/医疗补助计划及其他第三方支付方的规定。
