Practice or Perish: Why Bedside Toxicology is Essential to the Survival of Our Specialty

Skolnik, Aaron B.

doi:10.1007/s13181-012-0284-5

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…There are many options for the practice of medical toxicology [7]. These range from the full-time clinical practice of medical toxicology, a combination of the clinical practice of both emergency medicine and medical toxicology, working with regulatory agencies and working in various industries.…”

Section: Discussionmentioning

confidence: 99%

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Lessons Learned from the Reimbursement Profile of a Mature Private Medical Toxicology Practice: Office-Based Practice Pays

Thompson

Leikin

2014

J. Med. Toxicol.

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We previously reported the financial data for the first 5 years of one of the author's medical toxicology practice. The practice has matured; changes have been made. The practice is increasing its focus on office-based encounters and reducing hospital-based acute care encounters. We report the reimbursement rates and other financial metrics of the current practice. Financial records from October 2009 through September 2013 were reviewed. This is a period of 4 fiscal years and represents the currently available financial data. Charges, payments, and reimbursement rates were recorded according to the type and setting of the medical toxicology encounter: forensic consultations, outpatient clinic encounters, nonpsychiatric inpatient consultations, emergency department (ED) consultations, and inpatient psychiatric consultations. All patients were seen regardless of ability to pay or insurance status. The number of billed Current Procedural Terminology (CPT) codes for office-based encounters increased over the study period; the number of billed CPT codes for inpatient and ED consultations reduced. Office-based encounters demonstrate a higher reimbursement rate and higher payments. In the fiscal year (FY) of 2012, office-based revenue exceeded hospital-based acute care revenue by over $140,000 despite a higher number of billed CPT encounters in acute care settings, and outpatient payments were 2.39 times higher than inpatient, inpatient psychiatry, observation unit, and ED payments combined. The average payment per CPT code was higher for outpatient clinic encounters than inpatient encounters for each fiscal year studied. There was an overall reduction in CPT billing volume between FY 2010 and FY 2013. Despite this, there was an increase in total practice revenue. There was no change in payor mix, practice logistics, or billing/collection service company. In this medical toxicology practice, office-based encounters demonstrate higher reimbursement rates and overall payments compared to inpatient and ED consultations. While consistent with our previous studies, these differences have been accentuated. This study demonstrates the results of changes to the practice--reduced inpatient/ED consultations and increased outpatient encounters. These practice changes resulted in higher overall revenue despite a lower patient volume. In this analysis, the office-based practice of medical toxicology has higher reimbursement rates, nearly 2.5 times higher, when compared to hospital-based acute care consultations.

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Section: Discussionmentioning

confidence: 99%

“…Generating revenue for bedside clinical toxicology evaluations remains an essential component to the advancement and maturation of the specialty [7,15]. Financial metrics, however, must be evaluated in order to optimize reimbursement.…”

Section: Discussionmentioning

confidence: 99%

Lessons Learned from the Reimbursement Profile of a Mature Private Medical Toxicology Practice: Office-Based Practice Pays

Thompson

Leikin

2014

J. Med. Toxicol.

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“…We can teach important pharmacologic and toxicologic principles to students and nurses, as well as residents, fellows, and attendings from all specialties. In addition, practicing our specialty through increased consults provides great educational experiences for toxicology fellows and is important for the sustainability of medical toxicology [6]. While the benefits of a bedside consultation service are easier to measure, the impact of educating all health care providers is powerful though harder to quantify.…”

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confidence: 99%

Increasing the Visibility of Medical Toxicology in the Academic Hospital Setting Through Education

Bruccoleri

2014

J. Med. Toxicol.

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The Critically Poisoned Patient

Donovan¹,

Burkhart²,

Brent³

2017

Critical Care Toxicology

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Practice or Perish: Why Bedside Toxicology is Essential to the Survival of Our Specialty

Cited by 4 publications

References 16 publications

Lessons Learned from the Reimbursement Profile of a Mature Private Medical Toxicology Practice: Office-Based Practice Pays

Lessons Learned from the Reimbursement Profile of a Mature Private Medical Toxicology Practice: Office-Based Practice Pays

Increasing the Visibility of Medical Toxicology in the Academic Hospital Setting Through Education

The Critically Poisoned Patient

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