Chargemaster Optimization Review

Many healthcare organizations are not fully aware of the impact that an inaccurate/outdated Chargemaster can have on their bottom lines.   Failure to maintain accurate chargemaster data can dramatically decrease reimbursement and also can increase the amount of manual intervention required at the time of billing.

Quality’s Chargemaster Services

Quality will provide experienced consultants in revenue cycle operations with hands-on chargemaster/revenue integrity experience to conduct chargemaster reviews at client sites.  Quality consultants will complete a full chargemaster review by performing the following activities:

  • Conducting interviews and workflow observations with client staff whose work responsibilities require optimally functioning chargemaster systems (e.g., PFS, HIM, Case Management, etc.). These investigations will allow Quality consultants to identify areas of concerns and opportunities for improvements.
  • Performing an analysis of the data currently contained in the organization’s Chargemaster system(s) involves extracting Chargemaster data and submitting the data as input to the analysis process. The analysis will be performed using analytical software designed to assess the completeness/accuracy of the data and to identify problematic areas with the current set up.  Quality will examine the analytical results to determine the seriousness of the gaps, trends, and inaccuracies.  In addition, Quality will recommend a procedure for efficiently updating missing, inaccurate, and misleading data.
  • Quality’s consultants will determine the client’s operational baseline and will make recommendations for process improvements and other best practices. In addition, if requested, Quality’s consultants will make corrections to the charge description master and draft changes to the organization’s standards and procedures.

Quality will provide interim briefings of its findings as it proceeds with the data analysis.  Quality will also deliver a final report with the details describing its findings, conclusions, and recommendations.

Quality’s Credentials and Client Experiences

Quality’s Chargemaster and revenue integrity specialists have years of successful healthcare management experience working for acute care hospitals, clinics, and physician practices. They also possess operational experienced in revenue cycle management, patient access, charge capture, charge master integration, medical chart auditing, and reimbursement optimization.

Project examples include:

  • Managing Chargemaster consolidation and standardization for hospital organizations
  • Standardizing consolidating client hospital’s charge description master for Interventional Radiology into the corporate charge description master
  • Validating new hospital charges for an acquired hospital to optimize revenue capture
  • Cross walking pharmacy CDM, pharmacy system and pricing tool for standardization
  • Created and updated corporate policy and procedures for the revenue cycle department
  • Implementing EPIC, Oracle Health/Cerner, QuadraMed hospital and professional billing systems including expertise with charge description masters

Benefits to Your Organization

  • Improved financial results
  • Reduced denials
  • Reductions in regular-time and over-time labor hours
  • Quarterly updates processed more efficiently and effectively