The business case for physician charge capture

Ask a physician what they think about capturing charges, and it’s likely they’ll say it’s not a task they think they should be doing. They might say they don’t have the time, training, or interest to do their own charge capture, so they leave it to the back office.

As a practicing physician myself, I’ve heard my fair share of pushback against physician charge capture. Don’t make the mistake of giving in to that line of thinking — for organizations, not engaging clinicians to help in the revenue cycle process can have significant downstream financial and practice performance repercussions.

Physicians are the ones who know best what care was delivered — that’s indisputable. We’re at the point of care with the ability to input the right code and shore up documentation before it gets to the back office. By recording the care actually delivered in a timely manner, we have the power to get in front of any compliance or reporting issues, and the power to impact revenue by ensuring the organization is billing accurately for services truly rendered.

Here are four areas where physician charge capture adds important business value:

1. Higher revenue: When physicians capture charges, we’re making it easier for the organization to bill and get paid for the care we actually delivered. By owning this part of the process — capturing charges and documentation accurately instead of punting to the coding department or purposefully under-coding — we’re helping optimize the revenue cycle.

Coders typically don’t have the necessary information to select the best code as they are completely reliant upon what’s been documented. Without physician input, there’s no ability to improve documentation to reflect care actually performed, leading to lower revenue. At best, coders are chasing physicians to gather information in an attempt to code a charge properly. This is inefficient.

If physicians capture coding and document accurately the first time around, it ensures proper charges without the back and forth. And since RVUs impact the physician’s salary, it gives the physician more control over his or her personal bottom line.

2. Improved compliance: Since we’re at the point of care, physicians have the level of detail necessary to accurately document the charge. This is key. By capturing all the information that needs to go to the back office and the EMR, physicians can get ahead of potentially costly compliance issues. After all, correct coding is ultimately the physician’s responsibility. It is the physician, not the billing or coding staff, who gets audited. And errors can be very costly.

It’s also important to note that when physicians capture charges, we’re also capturing diagnoses. Making an accurate record of acuity is very important, as it impacts an organization’s ability to better take on risk and negotiate healthcare contracts.

3. Efficient use of shrinking human resources: By engaging physicians with the revenue cycle, not only are physicians adding value, but back office staff gain the ability to refocus on more strategic tasks, such as working on claims submissions, denials, and accounts receivable.

Of course, physicians and the back office will still need to collaborate, but they’ll be doing so on more forward-thinking tasks rather than correcting or changing earlier work. Giving physicians ownership of the up-front process improves practice financial success and gives the back office the ability to be more productive in other areas.

4. Visibility into physician and practice productivity: Healthcare organizations run on many different kinds of data, but their data on physician performance is typically poor. Without accurate charge capture, the organization isn’t getting attribution data on how an individual physician is performing, or how valuable a physician group is to the hospital — important data sets to have in order to run the business efficiently.

When physicians take responsibility for their own charge capture, it ensures their RVUs are accurately recorded and that they get credit for the work they have delivered.

I ran into this early in my career, where a hospital’s data erroneously reflected that my practice was performing worse than others in the areas of productivity, length of stay and readmissions. I knew this was absolutely not the case — the culprit was incorrect attribution data the hospital was using to measure my group. Once we took control of our charge capture and the massive amount of practice data that came with it, we were able to clearly show that our physicians actually had the best metrics within the organization!

These four areas demonstrate the value created when physicians do their own charge capture. When performed correctly, it benefits the organization’s bottom line, the physician’s reimbursements, and the workflow of the entire team.

With all that said, it’s never easy to change established workflows. The good news is that physicians don’t need to make a significant time commitment to take ownership of charge capture. Today, electronic charge capture can be fast, easy, mobile, and seamless with billing systems.

In the more than 20 years of my career, I’ve seen the charge capture industry make many advancements. Some applications have introduced intuitive options that are accessible on any device, flexible and configurable to each physician’s preferred workflow, and easy to use with a few clicks and taps. The best ones even offer tools to help physicians select the right code, based on bringing coder algorithms to the point of documentation.

While not all charge capture solutions are created equally, you should be able to evaluate and find one that meets your organization’s specific needs, leaving little excuse for not owning this important physician activity.

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