By Darshan Patel, President, Emergency Medicine and Hospital Medicine and Jamie Shoemaker, MD, Emergency Medicine Strategic Advisor
Ventra Health recently attended ACEP SA 2024 in Las Vegas. And, although Dr. Shoemaker has attended many, many ACEP events throughout his career, we were excited that this was his first time attending since joining Ventra as our Emergency Medicine Strategic Advisor. It was a fantastic event, and our team had a lot of great discussions. Darshan and Jamie compiled the recap below to highlight key topics discussed onsite.
Combating bad payer behavior
There was a significant focus on the inefficiencies and ineffectiveness of the current NSA processes. Despite winning IDR cases, many payers fail to comply with payment obligations. Discussions highlighted the misaligned incentives between payers and providers, leading to financial strain due to medical record requests, pre-pay audits, and level of care denials. These behaviors create additional stress on providers’ finances.
Coding and Documentation
Concerns were raised regarding data accuracy and transparency. Many attendees mentioned a lack of necessary reporting, which hinders their understanding of ongoing activities and outcomes. There is a clear need for improved reporting mechanisms to enhance both transparency and data accuracy.
Lack of actionable data
Attendees expressed the need for better data and analytics to ensure they have the information required to make informed decisions. The current reporting mechanisms are insufficient, and there is a demand for enhanced transparency and accuracy.
Advocacy
The importance of being informed and involved in legislative matters affecting Emergency Medicine was emphasized more than a few times. Current issues, including the most recent coding guidelines, were discussed, and attendees were encouraged to participate in advocacy efforts.
Hospital Employed Physicians
There was considerable concern among hospital-employed physicians regarding the accuracy of coding by the hospital’s coders. The additional burden placed on physicians due to inadequate EM coding training for coders was noted. We are considering initiatives specifically tailored for hospital-employed groups and health systems to address these issues.
Documentation requirements, payer behavior, and payment criteria have changed significantly in recent years. Ventra provides the resources to help emergency medicine practices assess their financial health, maximize reimbursement, and plan for the future.
Contact Us
