Balancing effective charge capture and compliance: 'It takes a village'

For all the talk about lowering the cost of healthcare in the U.S., there's still one way that hospitals are leaving money on the table … and in the hospital room, the emergency room, the ambulatory care clinic and the physician's office: Inefficient or incorrect charge capture.

And yet there are a number of ways to improve charge capture--and boost revenue--ranging from the simple (such as better training) to the cutting-edge (technology systems).

In the most recent eBook from FierceHealthcare and FierceHealthFinance, Improving Hospital Charge Capture, we interviewed revenue integrity professionals who face these challenges daily and revenue cycle experts who advise healthcare organizations across the country. From quantifying the financial impact to staying a step ahead of the auditors, organizations including Cone Health in Greensboro, N.C., and Humility of Mary Health Partners in Youngstown, Ohio share their lessons learned.

Karen England, assistant director revenue cycle operations at Emory Healthcare in Atlanta, talks about some of the low-tech ways to improve charge capture. "You must have physician buy-in. Even more important, you must have a physician champion to advocate for the program and participate in the informal communication channels," she says in the eBook. 

Technology plays a key role, as well.

Even the smallest hospitals report that improved charge capture processes generate $500,000 in additional revenue. Larger systems can increase revenue by millions of dollars by upgrading technology and workflow to accurately track charges and quickly submit billing.

"As we move more toward bundled payments, hospitals will have to really know their costs and be able to count on their charge capture processes to make sure those costs are properly tracked," says Rick Gundling, vice president healthcare financial practices at the Healthcare Financial Management Association.

When it comes to balancing charge capture and compliance, Janet A. Thompson, regional director of revenue cycle integrity at Humility of Mary, may have put it best: "It takes a village to get the right balance between charge capture and compliance," she says. "Transparency and communication make the difference."  - Gienna (@Gienna and @FierceHealthIT)

The eBook is free, and available to download here: Improving Hospital Charge Capture. 

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