A hospital’s monetary success is highly dependent on the integrity of the hospital Charge Master. A healthy, well-maintained Charge Master can mean the difference between gaining or losing millions of dollars in revenue or costs. The Charge Master file is the primary link and key data source for all of the different systems involved in the purchasing, dispensing, and financial billing operations of the hospital.
Every item on a patient’s bill is processed through the Charge Master. If the codes aren’t up to date, claims will be denied. Unless the charges for every service and item provided by your facility are included, they can’t be selected and billed. These omissions and incorrect codes negatively impact revenue and can create serious compliance issues.
An optimized Charge Master can pave the way for detailed analysis of a hospital’s purchasing, dispensing, and billing procedures. This type of in-depth assessment can lead to actionable opportunities for saving time, labor and money. If the Charge Master is neglected, it’s virtually impossible to make intelligent decisions in each of those important areas.
Failure to maintain this important data source can also open the door for audit by the Office of Inspector General, sometimes resulting in charges of fraudulent billing. HCPCS codes (Healthcare Common Procedure Coding System) codes and CPT-4 codes (Current Procedural Terminology) undergo annual changes. New codes are sometimes added to the list, others are eliminated or their descriptions are changed. Some new regulations may require specific codes to be bundled and billed together, while others require previously bundled codes to be billed individually.
Activara’s CDM Solution ensures that your hospital’s ChargeMaster is always accurate and up to date. Our CDM specialists can transform an expensive liability into a valuable asset that optimizes reimbursement, improves cash flow and prevents compliance issues.