RCM tip of the day: Examine clinical order entry systems to ensure a clean chargemaster

It is critical that hospitals and health systems routinely review their chargemaster for accuracy in its list of billable items so they receive proper reimbursement. Equally as critical is examining how the organization's clinical systems integrate with the chargemaster, said Elaine Dunn, vice president of system integration for Craneware, a value cycle company.

She recommended hospitals and health systems ask themselves the following:

  • When was the last time you reviewed the accuracy of orderable and chargeable procedures in your clinical system and the link to the charge record?
  • Has there been validation that an order for a specific exam is creating a charge with the correct current procedural terminology code, price and cost center?
  • Are there new charges in your chargemaster that have no corresponding charge mechanism in a clinical system?
  • Are there items in your clinical system that do not have a valid link to a charge?
  • Are charge triggers set up consistently across a service line and set to optimize revenue recognition?

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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