What is Charge Capture and how to Improve this in Revenue Cycle Management
What is Charge Capture and How to Improve this in Revenue Cycle Management
Charge capture is recording and posting of all encounters. During the process, all aspects of the care must be documented accurately into the medical record.
OUTSOURCE STRATEGIES INTERNATIONAL
8596 E. 101st Street, Suite H Tulsa, OK 74133
Revenue cycle management involves multiple activities such as patient registration, medical accounts receivable management, claim processing and more. Charge capture, a critical element of the overall revenue cycle is the capture of information for use in a medical claim document. Charge capture helps ensure that the practice captures all charges for services performed. Entering charges on a daily basis and conducting audits to check all charges ensure that the practice maintains a constant flow of revenue. Each of these charges is correlated to a standard clinical code – ICD-10, CPT, HCPCS along with appropriate modifiers. Professional medical billing and coding companies can correctly identify the diagnostic and procedural code, which is a crucial step toward capturing charges and identifying billing items, while physicians can focus on providing patient services. Poor charge capture processes often result in the loss of millions of dollars in revenue every year. For better revenue cycle management, it is important to understand where errors or missed charge capture happen throughout the entire billing cycle. Hospital staff should be trained to verify clinical documentation and charge capture accuracy, ensure patient and health insurance information is correct, and check that appropriate codes and modifiers are present. After a patient visit, back-end employees perform charge capture responsibilities. Healthcare organizations employ a charge master that links clinical codes to a price. The charge description master is an extremely complex file that is subject to continuous updates and requires continual maintenance. This file contains everything for which a charge may be made, including hospital services, all diagnostic and therapeutic procedures, equipment, supplies, drugs and professional services.
How to Improve Charge Capture at Your Hospital Establish central charging policies and guidance – Hospitals should organize consistent charge standards across departments. Reliable charge structure and descriptions make it easy for people to understand from department to department and help each other out. Provide proper training - Provider organizations must focus on employee training around CPT changes, bundling and unbundling. Your office staff should be aware of the CMS rules and current procedural terminology (CPT) codes that change frequently. Regardless of the system that is used to improve charge capture, it is important that all involved individuals have the proper training and awareness. It is important to implement solid quality assurance procedures for a smooth workflow. www.outsourcestrategies.com
(800) 670 2809
Encourage
regular
communications – Healthcare settings can develop a
communication process to link teams that are part of charge capture, such as clinical departments, charge description master and billing. Interdisciplinary teams can also come together on a regular basis to discuss charge capture; ensuring missing and incorrect charges are identified. Choose a reliable charge capture system – Various EMR-integrated solutions can be used to appropriately identify and capture charges. Such solutions will help hospitals to avoid paper-based methods of capturing charges. Make sure to use the right application that allows you to quickly identify •
what has been billed
•
what is 'missing' or unbilled and
•
methods for checking the accuracy and completeness of the billing
You can also use healthcare information system available now to automatically drop charges whenever possible. Consider regular billing audits - Performing regular billing audits using patient census, emergency department and admission/discharge information can help ensure you have correct charges for each patient. It is recommended that the audit conducted for services has a technical and professional component to ensure both charges were reported and accurately billed. Reviews help – Review lag times from date of service to billing/coding and lag times from service date to posting date and claim submission. Also, compare lag times to industry benchmarks to identify problem areas. Ensure that your •
workflows ensure the right charge at the right time
•
technical and professional component is accurately reported/needed, and
•
appropriate 'safety nets' to ensure the billing and coding are appropriate and accurate
Reliable medical billing companies enter charges on a daily basis and also conduct audits to check all charges for completeness and accuracy, thus ensuring that the practice maintains a constant flow of revenue.
www.outsourcestrategies.com
(800) 670 2809