Electronic 'superbills'. (Practice Management Clinic).

Perhaps the most important factor in managing practice revenue is the rapid, accurate, and efficient billing of daily patient encounters. In this endeavor, electronic "superbills" are superior to paper record-keeping systems (table).

As physicians, we are personally responsible for all coding, just as we are for dictating our notes and examining our patients. Why should we assume the risk and expense of hiring unnecessary data-entry personnel when user-friendly technology is available?

The figure depicts an initial screen that allows the provider to select the type and the level of a visit. After the provider makes a selection, a new screen pops up to remind the provider to select any modifiers, if necessary. Other screens then appear that list the ICD codes for Evaluation and Management and for any procedures that were performed. Finally, an encounter-session review screen appears that provides text descriptions of all encounters, modifiers, ICDs, and CPTs. The provider uses a stylus to select, sign, and save the document, and the visit is immediately electronically billed to the payer.

Table

Comparison of paper and electronic billing systems

               Paper                       Electronic

Personnel      Data-entry personnel        Provider records all data
               are required.               at the time of service.

Accuracy       No modifier reminders       Modifier reminders are
               are given; ICD and CPT      provided; ICD and CPT
               coding is less accurate.    coding is more accurate.

Cost           Form design, printing, and  Cost is minimal; updates
               updating is expensive.      are frequent and simple.

Functionality  Limited space on paper      All codes are available;
               superbill means a limited   each visit is electronically
               number of codes; system     recorded.
               requires paper records.

Dr. Isenberg is an otolaryngologist in private practice in Indianapolis.; [e-mail]