RCM tip of the day: Conduct chargemaster review to prepare for price transparency

Hospitals should conduct a comprehensive review of their chargemaster to prepare for the CMS' price transparency rule taking effect Jan. 1, advised Rebecca Marsh, vice president of advisory services at nThrive, a revenue cycle management company.

Next year, CMS will require hospitals to publish a list of their standard charges on the internet. They must present the information in a machine-readable format that can be easily imported into a computer system and update the information at least annually.

In addition to conducting a chargemaster review, hospitals should also prepare for the new rule by identifying potential risk areas and drafting criteria, policies and procedures to support their chargemaster structure and pricing model, Ms. Marsh said.

"Currently, there is no national criteria that identifies how hospitals should charge for services not defined by a Current Procedural Terminology/ Healthcare Common Procedure Coding System code. Organizations must be able to defend their structure and justify pricing based upon the cost and resources utilized," said Ms. Marsh.

She recommended that hospitals "assess the structure of your chargemaster for adequacy;" "ensure accuracy and completeness of coding within the chargemaster;" and "compare to and level up with industry best practice standards."

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.

 

 

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