Chargemaster and Charge Capture

Learn how to use NAHRI resources and CMS and HIPAA requirements to appeal inappropriate charge denials.

Explore the revenue integrity universe.

Learn how revenue integrity leaders helped their organizations meet the new requirements and what next steps they’re planning.

NAHRI Advisory Board member Caroline Znaniec, MBA, MS-HCA, shares how hospitals can identify and improve compliance with price transparency rules.

Q: Can you tell me if your facility charges a triage charge for the ED? If a patient comes in and gets triaged, has vitals taken, protocol for labs, and then leaves, do you charge a Level 1 Triage for this or write everything off? Also, do you charge a suture fee if the patents comes in to ED for just suture removal?

Preparing to comply with CMS’ Hospital Price Transparency final rule was no mean feat for revenue integrity professionals, and an already significant lift was made heavier by the COVID-19 pandemic. Learn how one organization used teamwork to adapt to changes in plan and meet their goals.

Q: Our system has a new vendor that is helping with charge capture. We were discussing surgery level charges and a comment was made about rounding that surprised me: We don't have to follow rounding rules to select the additional 15 minutes after the first hour. The vendor acknowledged that Medicare does have rounding rules, but because the rounding rules are not listed in or specifically tied to any surgery documentation, then the rounding rules don't apply to surgery. If the total surgery time was 61 minutes, then we would have one first hour charge and one additional 15-minute charge. The vendor assured us that this was a common practice throughout all hospitals. Is this true?