Coding and DRG Audit Processes, and ABF Maximisation at Western Health

Business Challenge

Like many hospitals with hardcopy medical records, Western Health had numerous issues with their Coding and DRG Auditing processes that they wanted to address with the implementation of BOSSnet.  Some issues included:

Resolution of these issues would certainly have a hospital wide benefit, because from an ABF funding point of view, Western Health wanted to ensure they were meeting Health Authority activity targets, and receiving appropriate funding.

Solution

In November 2011, BOSSnet was implemented across Western Health.  Within a short period of time, Western Health found that they now had an electronic record that could be accessed by multiple users at the same time and a process by which documentation queries could easily be responded to.  All patient information was stored in one location and was available in a timely manner with no time wasted checking multiple locations, and they had no more missing medical records.

The implementation of BOSSnet now provided the Coding Service with the foundations to enhance and further develop their Coding and DRG audit program.  Western Health worked with Core Medical Solutions to develop tools for their audit processes.  Various reports and eForms were created including:

Results

The implementation of BOSSnet has allowed Western Health to create a rigorous coding and DRG audit process that has resulted in significant improvements in their ABF reimbursements.  The BOSSnet implementation has also allowed Western Health to offer their Coding staff flexible work arrangements with many of them now able to work from home.  This has enabled them to attract and retain coders as they are often looking for this flexibility.  Since implementation, Western Health have not only consistently met activity targets set by their Health Authority, the have exceeded targets and generated a significant amount of additional funding as a result.

"Since the introduction of BOSSnet there has been a 185% increase in the coding and DRG audit process yield, which has led to significant additional revenue for Western Health."

Kate Hunt
Coding Manager
Western Health