Charge Reconciliation

How does your organization handle Charge Reconciliation? Is the responsibility of the dept. or does your Revenue Integrity department reconcile?

Comments

  • Daily responsibility of each Operational Department (except for those that are under Charge Centralization)
  • It is the responsibility of the department to reconcile their charges daily.  I do have one team member in place that trains and holds the departments responsible to ensure that the departments are monitoring their charges.  The departments send reports to the Charge Reconciliation Analyst once completed.  Our Revenue Integrity Team is notified and gets involved when charges and/or revenue direction opportunities arise.

  • We also have the operational departments responsible for their own charge reconciliation. That being said our Revenue Integrity Coordinators are assigned specific departments (multiple) and work with the department leaders monthly on reconciliation, charge capture challenges, late charges, etc. The coordinators  also watch Revenue and Usage for each of those areas at a higher level so they should see any unexpected swings.
  • If there is a late charge issue or edits that cause late charges, it may be important to increase hold or minimum days before initial billing - I think too many organizations jump to the "benchmark" of 3 hold days ignoring some of the late charge issues that result in adjustment claims or re-work  - it may be better in the long run to have a hold of 5 or  days for example and have a much higher percentage of correct claims - then work on the areas that have late charges/edits to resolve at the root cause and you may be able to slowly reduce the hold days

  • We also have the operational departments responsible for their own charge reconciliation. I would love one team member to train and ensure that the departments are monitoring their charges.  I feel like a babysitter most of the time verifying their work.

    I agree with vrinkle@hcpro. My days are set at 5 in a balance between monitoring departments and not creating rework for billing.
  • Is anyone willing to share their charge recon policy? 
  • What is the benefit to decreasing the hold period?  Our system is going from 5 days to 2. 
  • The above should read going from 5 days to 4 days.

  • thanks, this is amazing!

  • Thanks for the policy.  I would love to see any others.  We are in the process of moving to Cerner to do our Rev Cycle on.  Is there anyone out there on Cerner that would be willing to share?
  • We will be going live with Epic in August.  Is there anyone else who has implemented Epic?  Thanks in advance!

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