Tawnya Bosko, MHA, MSHL, MS, Vice President, The Camden Group: Hospital finance executives understand that most healthcare services are reimbursed at a negotiated or set fee that is not directly related to the charge for the service. However, defensible pricing has become a significant and growing concern for organizations. Reviewing the hospital charge description master in conjunction with payer contracts and reimbursement and right-pricing services in the CDM is an integral step to greater transparency; and it is an activity that allows organizations to better understand their costs in preparation for new reimbursement methodologies. Along those same lines, point-of-care cost estimates for patients and collections at the time of service not only improve transparency, but directly improve the system’s bottom line, particularly as deductibles and patient cost share continue to rise.
If you would like to share your RCM best practices, please email Carrie Pallardy at cpallardy@beckershealthcare.com to be featured in the “RCM tip of the day” series.
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