The practice of health care providers documenting and recording their rendered services and then submitting those charges to patients or insurance companies for payment is known as charge capture.
The hospital moves on to the Hospital Charge Capture process when a patient completes their visit. A healthcare organization has a significant opportunity to discover revenue leaks through charge capture. Did you know that a hospital can lose $36 million in revenue if it has 189,000 missed charges in a single month? Your recovered revenue will rise, your revenue integrity will be protected, and the revenue cycle will be enhanced by accurately documenting medical services and communicating them to the billing office.
Healthcare providers use Hospital Charge Capture to keep track of the services they provide to patients. Charges for procedures and supplies that are not properly captured or billed are one of the most common sources of revenue leakage. Although hospitals are aware that they are losing money, they are unaware of the extent to which incorrect coding and charging contribute to the issue.
The majority of hospitals lack the ability to see into their Hospital Charge Capture process in a way that enables them to identify specific revenue leakage sources and areas in which their actions are out of line with industry best practices.
Risks of Inefficient Hospital Charge Capture The greatest Hospital Charge Capture risks are found in departments with a lot of volume and revenue, as well as in areas with complicated coding requirements like pharmacies.
The discrepancy between the chargemaster data and pharmacy spending data can be a prime example of the problem. When reimbursable medications are not included in the chargemaster or are miscoded, this is one of the most common sources of leakage. A domino effect in the billing process can result from a single incorrect code affecting every transaction entered against it.
A straightforward typo in a patient’s medication log can result in a coding error. Without comparing the pharmacy spending data to the Chargemaster data and looking for specific products that were purchased but not correctly billed, there is no way to find such a typo.
With up to 40,000 line items in a hospital’s chargemaster, costly errors are likely to cost money in rework, fines, and penalties, as well as lost revenue. When you add all of that up, you get some significant losses that you could have avoided. To achieve revenue integrity, it is essential to determine the extent and origin of leakage.
0
