Washington County gets help with Medicare billing

WASHINGTON — Public health officials in Washington County say they plan to contract out work for Medicare bill coding on home health care, after a third party review suggested a professional coding support service could increase the agency’s revenue.

Public Health Director Emily Tokheim said outsourcing the work would ensure higher efficiency and effectiveness when the county sends bills to Medicare.

“Our nurses do their own coding with our agency,” she said. “They’re great at it, but they’re not experts. And so, we thought now would be the time — as we are looking to increase our revenue — to partner with a team who are experts in coding.”

According to Tokheim, the service provided by a company called MAC Legacy could increase the county’s income from Medicare charges by hundreds of dollars per patient.

“We asked them to review some of our previous charts … and just give us an estimate of, had they had a hand in our coding, been able to get a second look at the coding that our nurses do, what would have been the difference?” Tokheim said at a Board of Health meeting Thursday. “It was estimated to be $200-$300 for each (chart) that they looked at.”

Tokheim said the service would come with an explanation from the company about any changes it made to the county’s billing codes, at a rate of $50 per submission. Those reports will effectively train staff to improve their own practices moving forward.

“I don’t want this to be a long-term service that we use from them,” she said. “I hope that we can get some good educational pieces and not need to use their services after maybe a year or so … but I think it was very obvious from the audit that they sent that there will definitely be an increase in reimbursement through partnering with them.”

Washington County Public Health Fiscal Administrator Peggy Wood said the contract was month-to-month, meaning officials would have discretion about when to end it.

“If we decide after three months … the nursing staff feels more comfortable, if we wanted to not use their services, we don’t have to,” Wood said. “It’s very flexible in terms of how much you use it and when you use it, and whatnot.”

Board of Health Member and WCHC Chief Nursing Officer Andrea Leyden said the service would make things easier on nursing staff, in the meantime.

“Regulations change all the time, (current procedural terminology) codes change,” she said. “You’re doing the best that you can paying the codes, but knowing there’s someone behind you really scrubbing that chart to make sure that you’re coding appropriately helps.”

Comments: Kalen.McCain@southeastiowaunion.com