This is one of the most important questions a revenue cycle team should ask when evaluating any downtime solution, and it is one that many organizations do not think to ask until after an outage has revealed the problem firsthand. The downtime period is not just a clinical documentation challenge. It is a billing documentation challenge. Every patient encounter that occurs while the EHR is offline generates charges that need to make it into the billing system accurately and completely. How that data moves from the downtime system to the billing workflow determines how quickly and how completely revenue cycle operations can recover.
The short answer is yes, dbtech supports structured data export that facilitates billing system integration. The longer answer involves understanding what that export covers, what it requires from the organization’s billing and IT teams, and how the process fits into the broader post-outage recovery workflow.
What Downtime Data Is Relevant to Billing Recovery
Before addressing how the data exports, it helps to be specific about what data the billing team needs from the downtime period. The billing-relevant data generated during a downtime event includes:
- Patient registrations completed using downtime encounter numbers, including the demographic and insurance information captured at the point of registration that is required to create a billable encounter in the billing system
- Charge capture documentation for clinical services provided during the outage, which in a properly configured downtime environment includes the service type, the treating provider, the time of service, and the patient identification needed to match the charge to the correct account
- Clinical documentation completed through dbtech’s eForms that supports the medical necessity and coding decisions required for claim submission, including procedure documentation, diagnosis capture, and any complexity or acuity indicators relevant to the claim
- Consent and authorization documentation that payers may require as a condition of claim payment, which in a dbtech deployment is stored in the patient’s eFolder and accessible for retrieval during the billing review process
Each of these data categories has a different path from the downtime system to the billing workflow, and understanding those paths helps the billing and IT teams plan the post-outage recovery process before an event occurs rather than improvising it under pressure after one.
How the Export Process Works
dbtech’s bi-directional HL7 interface, which feeds patient data from the EHR into the downtime workstations during normal operations, also supports the structured export of downtime-collected data back into the EHR after restoration. For billing purposes, the most important element of this export is the patient registration data, which flows through the HL7 interface in the same structured format that the billing system uses for account creation.
The specific mechanics of the billing integration depend on how the organization’s billing system receives data from the EHR. In most healthcare organizations, the billing system receives encounter and charge data from the EHR through an interface rather than being loaded directly. When downtime registration data is exported from dbtech back into the EHR through the HL7 interface after restoration, it becomes available to the billing system through the existing EHR-to-billing interface rather than requiring a separate direct connection between dbtech and the billing system.
This means that for most organizations, the billing integration question is less about dbtech exporting directly to the billing system and more about the efficiency and completeness of the EHR reconciliation process. The faster and more completely the downtime data is reconciled back into the EHR, the faster the billing system has access to complete encounter data for the downtime period. For more detail on the full post-outage data reconciliation process, see our post on how to reconcile downtime data back into the EHR after an outage.
Charge Capture Completeness During the Downtime Period
One of the most significant billing risks during a downtime event is not missing encounter data but missing charge data. A patient who was registered, seen, and treated during a downtime event may have a complete registration record exported back into the EHR, but if the charges for the services provided were not captured during the outage, the encounter will be billed without complete charges and revenue will be lost.
dbtech’s eForms configured for charge capture documentation allow clinical and ancillary staff to document the services provided during a downtime event in a structured format that includes the charge-relevant data elements needed for billing. Rather than relying on staff to reconstruct what was done after the EHR is restored, the downtime-period service documentation captures charges at the time of service, which produces a more complete and more accurate billing record.
For organizations with ancillary departments, including lab, imaging, and pharmacy, that have their own charge capture workflows, the specific configuration of charge documentation eForms should be developed in collaboration with the revenue cycle team before the first downtime event rather than after one has revealed the gap.
What the Revenue Cycle Team Should Do Before an Outage
The billing-related preparation that produces the fastest and most complete revenue cycle recovery after a downtime event includes:
- Working with dbtech’s implementation team during the initial deployment to configure charge capture documentation forms specific to the organization’s billing system requirements, so that the data captured during an outage matches the format the billing system needs
- Establishing a defined post-outage revenue cycle recovery protocol that specifies who is responsible for identifying and reviewing downtime-period encounters, in what sequence accounts are reconciled, and what the target timeline is for having the downtime period billing complete
- Training revenue cycle staff on the post-outage reconciliation process before an actual event, using a planned maintenance window as a practice opportunity to walk through the workflow from downtime data export to billing system entry
- Identifying a revenue cycle lead who serves as the billing counterpart to the clinical downtime coordinator, ensuring that the revenue cycle recovery process is managed actively rather than absorbed into the general post-event workload without specific ownership
To discuss how dbtech’s export capabilities and post-outage data structure would work with your specific billing system and revenue cycle workflow, request a demo or contact our team.