Charge Capture is a very simple concept to grasp and a much harder one to implement logically. Basically, it is the process of capturing or accounting for all services performed in a hospital or other healthcare setting, by a physician to a patient. The problem that makes such a basic process a grandiose task is that hospitals have a vast number of departments and staff members who perform duties that are not all linked with ensuring the proper people get billed. Additionally, services are rendered out the hospital and practice settings – ambulatory centers, clinics, and nursing homes to name a few.
A patient would assume that he or she is charged according to whatever tests, medications, procedures, etc. are prescribed by the attending physician. But who is to say that these written directives are transposed to the billing system? It is a complex process that requires more thought than previously assessed.
One of the most difficult tasks regarding charge capture is when new procedures or tests are incorporated into the mix. The lab technician, for example, may know how to perform the desired test, but not what or how to bill for it. In order to capture this charge, proper coding, training, and usage techniques must be implemented in every step of the process. A properly administered charge capture process must be utilized in order to ensure precise charging.
Accurate charge capture is an essential function for all doctors, hospitals, nursing homes, rehabilitation centers, etc. Not only is this imperative in order to recuperate costs, but also in order to avoid serious legalities associated with what should and should not be billed.
When discussing the charge capture process in a hospital setting specifically, it may be necessary to have a position specifically designed for this task. A person, often referred to as the charge master, would head the entire operation, from the inception of new practices into the system, to coordinating information sessions on how to use the charge capture system effectively. It is not enough to have a system; you must have a system that everyone understands. This person would project manage all information distributed by insurance companies regarding charges, and distribute them properly to the specified departments, ensuring proper attention.
A review of the charge capture system can also be performed in smaller venues. A yearly review, for example, by a chosen professional, would ensure that the system is kept up to date, and training sessions could also be implemented at this time for new employees, or on new codes that have taken effect. Small practices are especially affected by this sort of review, and find it to be the most cost effective solution.
Whether done by review, or implementing an entire position to the cause, the charge capture system must operate correctly. This will ensure increased productivity in receivables and profit by minimizing insurance negotiations and rejection.
Reviewing the charge capture process is essential. In order to capture the appropriate coding and procedural codes needed to process claims, review your system to make sure it works. This task can be as simple as ensuring that the number of patient visits equal the number bills submitted. If it turns out this basic test fails, then your system does not work. You would be surprised at the number of patient visits that go unbilled – up to 6% in some studies. Another way to ensure a steadfast financial relationship in the healthcare field is to utilize charge capture solutions like maxRVU. The charge capture process can be maintained effectively if all parties maintain proper communication and keep opportunities for improvement a routine process.