Charge capture plays an essential role within the compliance regulations of every hospital and healthcare system. Accurate charge capture practices can also benefit healthcare systems financially. However, when charge capture is not accurate, a hospital’s bottom line can suffer because overcharging can be just as damaging as undercharging for a medical service. Providers who are looking to improve their financial performance need to evaluate their charge capture process. Here are two areas providers can review to ensure that they are staying compliant and keeping patient safety in the forefront of their practice during each visit.
Assess How Charge Capture is Being Recorded
One of the reasons inaccuracies occur in charge captures is typically due to gaps within technology. If these errors are happening frequently and on a large scale, the rework involved in correcting the issue can lead to increased healthcare administrative costs. In the ever-changing, digital world of technology, it is important that providers know how to properly submit charges electronically for proper billing. By transitioning away from solely paper-based entry systems or not using a combination of paper and electronic, this will greatly reduce data entry errors.
According to a 2019 article in Healthcare Finance, 84% of healthcare organizations rely at least partly on their Electronic Health Records (EHR) systems for charge capture. Half use it exclusively as their charge capture solution and just over a quarter, at 28%, use electronic, standalone solutions as part of their charge capture mix, while 27% still use a paper charge capture system. One of the most fundamental activities a provider can do with charge capture is to audit their billing on a regular basis. This will ensure that the correct charges for each patient were submitted.
One of the most efficient forms of charge capture is utilizing a system that is supported by smart device technology, such as smartphones or tablets. Providers can record their services using a capture application on their devices which allows them to enter charges efficiently. Since these charges can be submitted electronically, providers will no longer have to exchange paper charges back and forth within their facility. However, in order for this route to be successful, full adoption must be implemented and continuous education to ensure that all providers are using the same documentation process.
Accurate Medical Documentation
Due to the complexities of accurate medical documentation and the very evolving ICD-10 coding, proper charge capture is imperative. Accurate medical documentation is a critical aspect of billing within the revenue cycle process in the healthcare industry. If a procedure or treatment is not properly documented in the medical record by a provider or their hospital staff, the health organization could face a denied claim. When records contain inaccurate information or are incomplete, an immense amount of time and money must go into correcting the flaws within the document. When this issue is happening on a grand scale, the stress put on the revenue cycle process can have major consequences for the provider’s bottom line.
By ensuring that documentation is correct before it is sent to the payer, the flow of the revenue cycle can go uninterrupted and healthcare administration costs can be kept at a minimum. With healthcare administration costs make up roughly 30% of all medical bills, keeping that number low impacts not just the healthcare organization, but also those who are being billed for the treatment they received. If healthcare administrative costs were reduced in the United States, patients and their families could not only receive the care they needed without hesitation, they could shift their energy and focus to their recovery and long-term health goals and providers can focus on patient care and experience. They also would not have to worry about an unexpected health event bankrupting their family.
Signature Performance Alleviates Unnecessary Healthcare Administration Costs
More and more healthcare systems are finding that navigating the complexities of claims submission and all of the related revenue cycle functions to be overly cumbersome and driving up administrative costs. As part of the operational model, healthcare system leaders should consider working with an outside strategic partner. Strong financial performance takes the right resources that specialize and are highly knowledgeable in all aspects of the revenue cycle. The right partner brings economies of scale, optimizes technology investments, shares valuable insights and provides access to knowledgeable experts who ultimately drive reimbursements and reduce administrative costs.
We believe the healthcare system in the United States deserves only the best and that is what motivates our team to live our mission of reducing healthcare administrative costs for our clients. At Signature, our experience on both the payer and provider side of the business allows our dedicated team the opportunity to evaluate industry issues from a variety of perspectives, eliminate any static within communication efforts and create custom solutions that get to the core of some of the biggest problems facing the healthcare industry today.
To request more information about provider auditing, contact our team today!
Lori Hoffart is the Vice President of Provider Operations at Signature Performance Inc., in Omaha, NE. Signature Performance is an industry leader in reducing healthcare administration costs for private and public healthcare sectors. Our unmatched experience in serving both the payer and provider side of healthcare financial management allows us to implement innovative solutions for every administrative demand.