I am evaluating the financial and operational impact of maintaining RN presence in ambulatory clinic settings in addition to centralized triage models for RN billing purposes.
Specifically, I am interested in how organizations are justifying RN FTEs in non-HOD clinic environments.
Areas of interest include:
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99211 capture opportunities
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Incident-to billing support
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Care management time attribution
- Chronic Care Management (CCM)
- Principal Care Management (PCM)
- Transitional Care Management (TCM)
- Remote Patient Monitoring (RPM)
- Centralized Triage Management Services
- Etc.
In our organization, there is a perception that RN only encounters do not generate billable opportunities outside of narrow E/M scenarios, 99211. I am seeking data from other systems to understand more opportunities. I know all states can be different, but I'd like the opportunity to at least explore them.
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Are you capturing measurable revenue tied to RN presence in clinic?
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Have you quantified lost billing opportunity when RNs are removed from practices?
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How are you aligning RN scope with value-based reimbursement structures?
Any shared metrics, models, specific billing practices, or lessons learned would be greatly appreciated.
Shaun Glass, MSN, BBA, RN
Director of Nursing
Wellstar Medical Group, Nursing Services
shaun.glass@wellstar.org
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