McKenzie Hospital

Increasing profitability with accurate billing

Increase in gross accounts receivable

McKenzie Hospital asked Wipfli to review its emergency room chargemaster to ensure compliance with CMS billing and coding requirements. Wipfli uncovered unbilled services and training opportunities that increased profitability.

The Challenge

Without clear guidance from the Centers for Medicare and Medicaid (CMS), hospitals had to develop their own criteria for charging emergency room encounters. McKenzie Hospital wanted assurance that its methods complied with CMS billing and coding requirements.

The Solution

McKenzie Hospital called on Wipfli for its extensive experience and proven methodology for chargemaster reviews. Wipfli assessed the hospital’s ER chargemaster and related tools and interviewed billing, coding and nursing staff to understand the billing process.

The results

Our assessment uncovered unbilled services, such as surgical procedures, observation and bedside services. It also identified improvements to the charge ticket design and easy-to-use methods to help McKenzie Hospital determine compliance. Education and training needs also became clear. With feedback from the review, McKenzie Hospital trained clinical staff on focused billing issues. The hospital also updated its chargemaster to include more procedures and accurate billing codes. These changes increased the hospital’s monthly gross accounts receivable by $70,000.

© Wipfli LLP. "Wipfli" refers to Wipfli LLP, a Wisconsin limited liability partnership, and its subsidiaries. Assurance, tax and consulting services are offered through Wipfli LLP. Investment banking and related services are offered through Wipfli Corporate Finance LLC. Wipfli LLP is a member of Allinial Global, an association of legally independent firms. ”Wipfli CPA” is the DBA name of Wipfli LLP in New York state, and refers to Wipfli LLP.

Increasing profitability with accurate billing

The Challenge

The Solution

The results

Services Engaged