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- The EN-Chart Coder is a dynamic software solution with proven success at optimizing revenue and reducing compliance risk for emergency department facility billing and charge capture.
EN-Chart coder prompts the user, through discreet entry fields, for information regarding the patient visit. Our software then determines the appropriate level of service (E&M Level) by measuring the amount of time and resources spent on treating the patient. A site customizable weighted points system automatically identifies the appropriate level. Medication administrations and procedures which should be billed in addition to the level of service are also identified and coded. Current CMS billing rules are accounted for in EN-Chart coder, and logic and algorithms are kept updated to apply the latest rules.
EN-Chart Coder is installed on a local server in your hospital. The actual work of abstracting the chart into our tool can be performed by dedicated staff in the emergency department, HIM, or medical records. The emergency department manager uses the tool for administrative reports and other supervisory tools.
EN-Chart Coder will save time and money by eliminating coding and
charge capture subjectivity. Emergency Department nurses no longer need to complete a charge sheet, leaving more time for patient care. EN-Chart keeps the tool current, so coders simply need to be able to abstract the required data from the completed chart, instead of struggling to keep up to and apply complex rules. The finished summary sheet maps the appropriate codes and charges all the way to the hospital charge master. So after final review, the charges can be sent electronically to the hospital billing system, saving significant FTE data entry time.
EN-Chart Scanning Program is the first scannable Emergency Nurse chart available on the market. This program was designed to help nurses save time when filling out charts and to provide real time feedback on documentation deficiencies. It eliminates the need to abstract the chart to identify billable CPT/HCPCS codes.
EN-Chart is an emergency nursing paper template chart that is designed to meet JCAHO and CMS billing rules. The scanning program complements the paper template by using Optical Mark Recognition (OMR) to read key data fields as documented on the paper chart by the ED nurse. As the scanning program interprets the form, APC billing rules are applied to identify applicable procedures and to calculate an evaluation and management (E/M) facility code.
EN-Chart is the first known emergency nursing template that uses OMR to interpret the information documented by the ED nurse. Other paper templates have been used, but must be manually abstracted by a coder or the nurse must enter charges onto a charge sheet to capture charges and codes. EN-Chart applies all APC billing rules by reading the actual nursing documentation.
- Reduced costs – reduction in paper costs, copying and duplication of work efforts for charge capture
- Accuracy – a > 99% capture of documented procedures
- Compliance – applies APC billing rules consistently and has an automated tool to calculate the ED visit level
- Timeliness – charts can be scanned and coded within seconds
- Data capture/audit trails – data is captured when the chart is scanned and allows the information to be queried for statistics and trends
- Enhanced documentation – prompts complete and compliant information for risk management, billing and data capture
- Chart is completed (short or long form)
- Nurse documents care provided
- Chart is scanned into EN-Chart
- EN-Chart interprets information on chart
- Error messages are provided on-line
- Correction made to chart and/or into EN-Chart
- Coding summary page is generated on-line and printed
- Information is entered into hospital billing system or sent via an interface
- Data is stored in EN-Chart database for future queries
EN-Chart is formatted to allow the OMR criteria to easily read the information documented by the ED nurse. The forms must be properly printed with effective nurse documentation in order to accurately read all information on the chart and to apply the designated coding rules. Accuracy rates have reached >99%.
The EN-Chart short form (one duplex form) can be scanned and interpreted in less than one minute. The EN-Chart long form (two duplex forms) can be scanned and interpreted in less than 2 minutes. Corrections to errors can be made on line very quickly. The coding summary page is displayed on-line and can be printed to a laser printer within seconds.
Information will include patient identification information, all procedural codes captures by CPT/HCPCS number and CPT description, all intervention used to calculate the ED visit level by name and point value with the total sum and its associated CPT/HCPCS code as well as if the chart was signed.
EN-Chart can accept both an ADT demographic interface and an outbound billing interface based on hospital specifications.
EN-Chart is excited to offer, through partnerships with emergency department information systems (EDIS) vendors, a model wherein our coding tool is fully integrated with electronic charting.
In addition to all the benefits that are realized through stand alone implementation of EN-Chart coder, the integrated model typically provides:
- Real-time coding summaries to clinicians
- Real-time identification of charting deficiencies that may affect revenue or compliance
- Elimination of all data entry for coding and charge capture. The integrated model receives all the necessary clinical information as a by product of electronic charting.
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