Chargemaster – Critical Tool for Revenue Cycle Management
Course Description:
A hospital chargemaster is a comprehensive list of a hospital's products, procedures, and services. Everything from prescription drugs to supplies for diagnostic tests has a unique price listing in the chargemaster and is used by hospital administrators, clinical documentation improvement specialists, and revenue directors.
Chargemasters include the following information:
- The charge for a single unit of service
- A correct CPT code as described by the American Medical Association
- HCPCS II codes as applicable
- Alternate CPT & HCPCS codes that may be required by a specific payor
- A revenue code associated with the charge (Cost center that receives the revenue)
- Flags that indicate active, inactive charges or charges scheduled for deletion
- An internal general ledger number
Chargemaster rates serve as baselines when negotiating rates with payors but do not necessarily indicate the true costs of providing services. They should be updated at least annually, when new services are established, when current services are being discontinued and when percentage rates are increased.
Inadequate chargemaster management leads to revenue leakage in the following areas:
- Multiple departments entering charges
- Chargemaster may be incorrect or incomplete
- Error in number of units selected
- Error in item selection
- Inactive charge
- New service not added
- Incorrect revenue code/cost center
- System conversions
- Overreliance on claims scrubber
Learning Objectives:
- Understand chargemaster functions
- Understand revenue leakage resulting from poor chargemaster functions
- Understand why correct departmental charging is vital to revenue integrity
- Appropriate training for charge entry staff
- Billing attention to posted charges
- Accurate charges enhance patient satisfaction
Areas Covered in the Session:
- What is a chargemaster?
- Revenue Management
- Chargemaster Example
- Creates Patient Dissatisfaction
- Inaccurate Billing May Cause
- Why Errors Occur
- Prior to Charge Entry
- Charge Entry Problems
- Potential Problems Post Entry
- Billing Staff
- Inpatient hospital Room charges
- Common Medication errors
- Medications
- Supplies
- Laboratory
- Radiology
- Surgical Procedures
- Therapy Departments
- Therapy Services
- Behavioral Health Department
- Cardiology Services
- Pain Clinic
- Medicare Inpatient Only Procedures
- External audits
- Process Improvement
- Final Tips and Reminders
Suggested Attendees:
- Chargemaster Maintenance Staff
- Physicians
- Practice managers
- Medical assistants
- Nurses
- Compliance staff
- Billers
- Coders
- Revenue Cycle
- Risk Management
- Charge entry staff
- Revenue Cycle Managers & Staff
- Billing Manager
- Clinical Documentation Staff
- Finance Managers
- Denial Management Staff
- Non-Physician Providers
- Mid Level Providers
- Claims Follow Up Staff
About the Presenters:
Dorothy D. Steed, MSLD, CCS, CDIP, COC, CPCO, CPUM, CPUR, CPHM, CPMA, ACS-OP, CCS-P, RCC, RMC, CEMC, CPC-I, CFPC, PCS, FCS, CRCR, CICA, CPAR is an Independent Healthcare Consultant and Educator in Atlanta. She has served as Medicare specialist and a physician audit supervisor for hospital systems with 46 years of experience in healthcare. She is an instructor at a state technical college in Atlanta and provides auditing & training in both facility and physician services. She is credentialed in medical coding, medical billing, medical auditing, utilization management, healthcare management, healthcare compliance, clinical documentation improvement, revenue cycle and patient accounts. Additionally, she has participated in multiple healthcare audits and investigations for both plaintiff and defendant.
Snippet From Our Previous Session:
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Email: care@skillacquire.com