Improving Charge Capture Revenue recovery and Charge Capture account for a substantial and significant impact to the facilities bottom-line.
Every Revenue generating department within the hospital must properly document and record charges in order to establish control mechanisms to ensure that appropriate procedures and charging protocol are being followed. How to improve charge capture? One of the common causes of overlooked revenue is related to missed charges. These are charges related to supplies, devices, services and procedures that were rendered but never billed. Missed charges may prevent the hospital from accumulating enough dollar value to hit an outlier, which also results in missed revenue opportunities. The key to improving charge capture and reducing the revenue loss is to ensure that proper charging protocol is being followed initially. There are several ways to identify where charge capture needs to be improved. Concurrent Audits: Hospital should develop a program to perform concurrent audit (complete audit on non-disputed accounts within 30 days of patient discharge). The sample should include a random query of inpatient and outpatient accounts. Defense Audits: Preparation of defense audits against payers. Providing evidence for itemized charges prior to exit conference. Focus Audits: Hospitals should perform audits or charge capture review on revenue generating departments, such as pharmacy, radiology, OR, ER. Based on monthly error reports generated by concurrent audit statistic. Charge Description Master (CDM): Working with facilities CDM analyst to ensure coding and charge capture. Audit Department: Creating a separate revenue and audit department staffed by an experienced nurse auditor with strong clinical and billing experience to look for charge capture issues on a daily basis. As well as meeting with department managers to determine cause for over and under charges and corrective actions that will need to be taken by the departments to rectify proper charges. Charge Protocol: Maintaining and developing charge protocol and policies in all revenue producing departments in order to ensure proper implementation of all corporate charge protocols are in place and are being followed. At American Healthcare Audit professionals, we have experience and knowledge of Standards of Care, Policy and Procedures, Critical Pathways, HIPAA guidelines per facilities. Our highly experienced staff of Nurse Auditors and Certified Professional Coders includes Nurse Practitioners, Master Prepared Registered Nurses and Certified Medical Audit Specialist. In order to learn more about our services, please visit our website in order to discuss your specific needs and initiate implementing these and other services within your facility, clinic or physician group - contact us on line or call us at 888-816-7758 Ext: 2. Sincerely, Michelle Simmons Office Administrator American Healthcare Audit Professionals, Inc. Phone: (949) 448-8296 Ext: 2 Fax: (949) 203-2298 Web: https://www.ahapinc.com/
