The chargemaster – frequent culprit of lost revenue, incorrect billing and compliance risk
The charge description master (CDM) is the foundation of charge capture, coding, pricing and billing accuracy for healthcare organizations, and at the center of healthcare and cost data communicated to both patients and payers. Regardless of whether a procedure is 'hard-coded' or 'soft-coded', the CDM must be up-to-date at all times and accurately represent the services offered by each department so assigned codes have a charge line available for capture.
However, the CDM is frequently the culprit of lost revenue, incorrect billing and compliance risks. Why? Because the demands related to CDM maintenance are constant. Between quarterly updates and revisions to CPT®/HCPCS codes, payer updates to contract language, contract management requests related to payer-specific carve-outs and a regulatory environment in a state of flux, CDM maintenance is a daunting task. The struggle to meet best practice standards, and strive for improvement, in the face of multiple layers of coding and regulatory complexities is felt by seasoned professionals and healthcare organizations across the country.
Additionally, accuracy is under scrutiny now more than ever. The CDM that was once protected under a cloak of secrecy is now published on the web and readily accessible to the general public including individuals and focus groups looking to highlight inaccuracies and questionable charges. All of this adds urgency to the need for CDM accuracy.
We can help empower your facility to take charge of these challenges.
Leading revenue integrity expert Robin Miller Zweifel will provide a breakdown of essential practices (and actionable tips!) for maintaining your CDM along with what your chargemaster software resource may, or may not, be identifying about coding accuracy, alignment of related procedures and rational pricing.
What's on the agenda:
- Discussion of best practice management and CDM maintenance workflows
- The role of data integrity in maintaining a rational and logical relationship for related services with consideration of cost and accurate calculation of final billed charges
- Identification of common CDM errors and how to overcome them
- The importance of coordination between departments to ensure best practices for CDM management – including IT to identify information system program logic masquerading as CDM inaccuracies
- Correlation of shared data for pharmacy and supply charging
- Effective correlation of data for synchronization of multi-facility CDM as chargemaster management now integrates processes for clinics, provider-based extension of hospital services and the hospital itself
- Understanding the Place of Service (POS) impact on code selection, charge capture and billing
- Utilizing online, paper and embedded reference documents and resources for CDM management
CPT® is a registered trademark of the American Medical Association.