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46 – Annual Tasks: Chargemaster analysis
9 Plays17 days ago
As a last stop, let’s review nine tasks that should be completed on an annual basis. The first task that you should complete annually is conducting a chargemaster analysis.
View the full report online: https://www.hstpathways.com/resources/surgery-center-industry-report/
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Transcript
Introduction to Annual Chargemaster Tasks
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As a last stop, let's review nine tasks that should be completed on an annual basis.
Importance of Chargemaster Analysis
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The first task that you should complete annually is conducting a Chargemaster analysis. The Chargemaster serves as a comprehensive listing of all billable services and items the Surgery Center provides. It plays a pivotal role in revenue cycle management, serving as the foundation for billing and coding processes.
Updating Chargemaster for Compliance and Competitiveness
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Annual updates ensure that billing remains compliant with current regulations, that all charges reflect the most recent costs and negotiated payer rates, and that the facility remains competitive and financially sustainable.
Capturing Revenue and Building a Chargemaster
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Proper oversight and diligence in this process are paramount to ensuring the surgery center captures all revenue rightfully owed while avoiding potential compliance pitfalls. When reviewing your Chargemaster, most will build it based on a percentage of Medicare's reimbursement.
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You can perform the analysis yourself using a tool that is as simple and free as Microsoft Excel or Google
Technology's Role in Chargemaster Management
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Sheets. However, leveraging technology solutions like automated Chargemaster management systems such as HST can help save time and reduce errors.
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Next, let's walk through the key process steps for this phase.
Step-by-Step Chargemaster Review and Updates
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Step 1. Start with a thorough review of the current charge master, noting any items that seem outdated, incorrect, or missing. Step 2. Review updates from CMS and other regulatory bodies to identify any required changes to coding, pricing, or billing practices. Step 3. Learn your contracts inside and out, as there might be increased limitations and other requirements.
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Step 4. Analyze the current market rates, payer contract terms, and the center's own cost structures to adjust pricing as necessary. Step 5. Before finalizing changes, test the updated charge master in your billing system to validate that all codes and charges are processed correctly.
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Step 6. Conduct training sessions to inform and educate relevant staff about changes to the charge master and its implications. The
Monitoring and KPIs for Chargemaster Success
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following key performance indicators will help you track your success. Percent of the cases you capture 100% reimbursement for hint, if it's all of them, you are likely undercharging.
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The time it takes to perform an audit and the accuracy of your audit.