At Grady Health System in Atlanta, monitoring key performance indicators (KPI) always comes back to the foundation KPI: hospital late charges. The timing of posting charges has a ripple effect. The longer you wait to post a charge, the more likely it is you will miss something.
In the game of tug of war, will it be clinical or revenue integrity staff members who stand up to the challenge? When it comes to charge capture, it can be a struggle to know who should be held accountable.
The methods for maximizing revenue capture have changed over the years. Revenue management has evolved from random chart audits to using data analytics and technology to find patterns.
As revenue integrity departments continue to evolve, facilities are often faced with the challenge of determining which tasks must fall to these departments and which are best suited for other revenue cycle roles. With so many department functions overlapping, defining revenue integrity-specific functions is a complex task.
There are two parts of maintaining correct audits: ensuring that the charges present on the claim accurately represent the care provided and documented and ensuring the claim is compliant with all applicable billing rules and regulations. One way to ease the process is to review the charges on the claim with an application or tool that can predict errors using the analytics from outpatient Medicare claim data.
Is your hospital’s chargemaster updated for 2017? Learn about the latest billing and coding changes affecting the chargemaster and how to ensure your hospital’s chargemaster is in top form to help ensure revenue integrity....
