The primary value of a trauma program is its service to the community. Still, financially, it’s typically a cost center due to the high cost of acute care, resource-intensive services, and reimbursement challenges. There is rarely an expert in trauma coding and billing on hand, adding to the risk that reimbursement opportunities will be overlooked.
However, strategically leveraging the trauma registry for billing can help hospitals increase reimbursement, drive revenue, and close the billing gap. By some estimates, hospitals across the country lose more than $100 billion per year collectively due to missed reimbursements.
Continue reading to discover how to leverage registry data to close the billing gap in trauma and increase reimbursement rates hospital-wide.
The Role of the Trauma Registry in Billing
By design, the trauma registry is a trove of data that can be leveraged for many uses, including by clinical teams, administrators, and financial services. The registry is a comprehensive database that captures detailed information on trauma patients and their care, from pre-hospital through discharge.
The registry can serve as a single source of truth for granular data that supports billing teams by ensuring that every billable service is accounted for. Registry data is also subject to high regulation and scrutiny, with data being validated, checked, and rechecked for accuracy and completeness. This positions the registry to serve as strong supporting documentation for appeals in the case of claim rejections.
How to Use the Trauma Registry to Drive Revenue
An advanced trauma registry does more than collect data—it’s a tool for improving billing and reimbursements. Here are three ways you can use your trauma registry to drive revenue across your entire hospital system.
1. Connect Registry and Coding Teams
Work with colleagues in finance to establish protocols for regularly auditing billing submissions using registry data. A registrar, for example, can coordinate with billing and coding teams to ensure that all trauma-related charges are accurately documented, categorized, and submitted.
Look closely at ICD-10, CPT, and revenue codes to spot discrepancies before submitting claims to reduce denials, improve first-pass acceptance rates, and reflect patients’ complete scope of care.
Revenue losses commonly occur in cases of repeat imaging, anesthesia during trauma surgery, secondary procedures, and ICU critical care charges not being fully documented. This is the perfect opportunity for interdepartmental collaboration and education.
Review what constitutes critical care for billing purposes and go over the nuances of activation thresholds. For example, since critical care codes are time-based, review start and stop times for critical care billing.
2. Integrate Hospital Data
Connect your registry with your EHR to address one of the biggest challenges in trauma billing: accurate coding and charge capture. Ensure that every procedure is accounted for with proper codes. Coding specialists can cross-reference diagnoses and procedures in one secure location.
Ultimately, your registry’s ability to help close the billing gap depends on the quality of the data. Incomplete or incorrect records won’t reveal anything valuable. Interoperable registry systems can bring in data from your EHR automatically, removing errors from manual entry, where it undergoes another quality review.
The Inter-Rater Reliability Score in ImageTrend Patient Registry can automatically flag inconsistencies and incomplete codes.
3. Boost Your CMI
Case Mix Index (CMI) is a measurement of the average complexity and resource needs of a hospital’s patient population. Centers for Medicare & Medicaid Services (CMS) use it to calculate reimbursement rates, and hospitals can use it to allocate resources.
Because injury, treatment, and severity factor into a CMI score, a trauma program in the hospital, and each procedure it registers, usually boosts the CMI.
The best part is that CMS applies the CMI hospital-wide, increasing reimbursement rates beyond trauma. The same applies to commercial payers. A higher CMI justifies negotiations for a higher payout from payers beyond CMS.
And the financial impact can be significant—according to the AHA, U.S. hospitals were underpaid by Medicare and Medicaid by more than $125 billion in 2022 alone. A higher CMI helps offset these shortfalls and supports financial stability across departments.
Keep in mind that even if a trauma activation is not reimbursable by CMS, it still goes into your Hospital Cost Report, which contributes to raising your CMI.
Put Your Registry to Work
Your registry is a powerful tool for reducing missed charges and increasing reimbursements through accurate documentation and coding. Talk to an advisor to learn how ImageTrend Patient Registry can maximize your ROI with ease.
