Charge capture is a vital component of revenue cycle management (RCM) in healthcare. It is the process of accurately recording and reimbursing all services offered to patients and ensuring that medical practices receive complete reimbursement.
As healthcare reforms take place in the United States, practice administrators, owners, and IT managers must develop effective strategies for optimizing charge capture. This will help reduce revenue loss and improve the company’s financial health.
Implementing charge capture best practices is essential for healthcare organizations aiming to improve billing accuracy and maintain financial stability. By leveraging technology-driven solutions, standardizing documentation, and ensuring real-time data entry, providers can reduce errors, minimize lost revenue, and enhance compliance.
This article provides several key methods to improve charge capture, focuses on the importance of technology, and discusses the effect these strategies could have on revenue generation.
Charge Capture: An Overview
Charge capture consists of recording the services provided to patients, codifying these services precisely, and billing them appropriately. Inadequate charge capture could cause a significant revenue loss and can cost as much as one per cent of a health system’s net costs. With the tight margins for profit in healthcare, ignoring revenue potential can severely affect a clinic’s financial health.
To reduce revenue loss, effective processes must be implemented to ensure accurate capture of charges from the time a person arrives until payment is made. This is a must for patient registration, confirming eligibility, and processing claims submission and coding.
Identifying Key Areas for Charge Capture Optimization
To improve the effectiveness of charge capture, medical practices must focus on the following areas to be “hotspots” for improvement:
Emergency services: Facilities often face challenges when documenting emergency services because of the high volume of patients. Templates to implement standard processes can facilitate the process of recording charges and reduce the amount of oversight.
Operating Room Services: This part often causes confusion between soft-coded and hard-coded items, which could lead to unpaid charges. Software designed for charge capture can identify discrepancies and ensure that all eligible services are properly billed.
Pharmacy Services: As the biggest cost centre within numerous healthcare systems, capturing charges in pharmacies can be challenging when converting dispensing units into billing units. Regular software support and periodic reviews will help ensure accuracy in this particular area.
Supply Chain and Devices: Accurate code assignments are crucial. Facilities should ensure they have used the manufacturer of the codes they recommend to avoid mistakes in charge capture.
The Charge Description Master (CDM) Mapping Proper CDM mapping is crucial to ensure accurate charges. Many departments lack sufficient technical coding abilities, which can lead to revenue loss. Training can help improve coding accuracy.
