313 A Team-Based Learning Approach to Reimbursement and Billing Education for Emergency Medicine Residents

Abstract

In this paper, we detail the advancement of our billing, coding and reimbursement education within the Health Policy and Advocacy Curriculum, as well as measure the effectiveness of our approach to improving resident knowledge and comfort of documenting and coding emergency medicine encounters. We developed a billing and coding curriculum to assess whether an educational intervention would improve billing and coding knowledge and comfort. The session was formatted as a traditional TBL small group session during a full-day workshop for emergency medicine residents and advanced practice practioners at an urban academic medical center. A pre-post design was used to evaluate understanding of commonly used billing codes in emergency medicine and comfort submitting billing codes. Data for continuous variables were analyzed using the student t-test function of Microsoft Excel. Learners comfort with understanding the 6 different evaluation and management commonly used in emergency medicine significantly increased from 35.3 out of 100 to 74.2 out of 100 (p<0.0001). The learning objective of distinguishing between new (eg, alternative payment systems, bundled payment) and older (eg, fee-for-service) payment systems increased from a knowledge level of 23.2 out of 100 prior to the TBL and 53.2 out of 100 afterwards, a significant 30-point increase. (p<0.001). Learners also had a 46.5-point significant increase in their self-rated comfort placing billing charges for patients self-rated their comfort placing billing charges (p<0.0001). The significance was preserved when learners from BCM were isolated from the all participants. This study demonstrates that TBL can successfully be used as part of emergency medicine residency curriculum to teach billing and coding. Our reimbursement TBL exercise demonstrated significant gains in self-rated knowledge for the three learning objectives pertaining to emergency medicine reimbursement affiliated with our broader health policy curriculum. We recommend more widespread use of active learning methodologies to teach “nontraditional” components of curriculum, such as billing and coding