Undervalued Services

Emergency departments (EDs) have a unique challenge that is not seen in typical outpatient settings. They need to maintain 24-hour readiness to handle a range of care that includes everything from the local community’s daily healthcare issues to an unprecedented regional disaster….all at a moment’s notice. Providing exemplary care in this unplanned and sometimes chaotic environment makes accurate and consistent service valuation a difficult goal to achieve. Often there is tendency to downcode and “play it safe” to avoid the possible consequences of an unfavorable payer audit.

LYNX E/Point^® is a software application that promotes compliant and consistent facility and professional charging, diagnosis and procedure capture in the emergency department. The E/Point presenting problem-based methodology uses the LYNX ED algorithm to calculate facility visit levels, the LYNX professional charging module to calculate professional visit levels and the LYNX infusion algorithm to calculate charges for infusions and injections. The methodology complies with 11 Outpatient Prospective Payment System (OPPS) guidelines outlined by CMS, and produces an E/M visit level distribution that accurately reflects patient acuity mix and resource use. As a result, hospitals are now able to receive full credit and reimbursement for the services they provide