Charge Reconciliation
How does your organization handle Charge Reconciliation? Is the responsibility of the dept. or does your Revenue Integrity department reconcile?
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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.
I agree with vrinkle@hcpro. My days are set at 5 in a balance between monitoring departments and not creating rework for billing.
The above should read going from 5 days to 4 days.
thanks, this is amazing!
We will be going live with Epic in August. Is there anyone else who has implemented Epic? Thanks in advance!
Does anyone have any Epic policies they would be willing to share?
I know your pain. Even after 7 years, I still mourn the loss of my AS400 queries. Maybe we could develop a support group?
May I ask what report you are using in Cerner for charge reconciliation? We have been trying to find a good report in Cerner for this.
I too relied on AS400 queries for so much process improvement and workflow in the revenue cycle and none of these newer patient accounting systems have the power that AS400 had - I have not seen any "canned" or standard reports from a PAS that facilitates charge reconciliation.
Charge reconciliation is the responsibility of the departments. My RCI team does monitor it and if we see a problem with a department we address it with the dept leadership.
How is your team monitoring these charges? Can you share please?
We use the Revenue Guardian Report in Epic, departments indicate a charge has been reviewed there and we run weekly reports to monitor their use.
I use the Charge Query Report and download the daily charges to Excel. I filter on different Activity Types to see if there are any trends--days missing charges, reversed charges, low volume, late charges, etc. I also teach the departments to run reports for their areas. I also use it to look for blood products without transfusion charges, high dollar charges, wrong cost centers, incorrect rev codes (like IP dialysis charges on OP encounters), etc. It was all I had in the beginning.
Hi!
I went from AS400 to Cerner and now I'm in Athena Health. Is anyone familiar with this platform?
We have implemented a comprehensive charge reconciliation process where each revenue-generating facility/department is required to review their charges within 24-72 hours of the service date. After the review, they must submit an acknowledgment to confirm the review, with a comment section available for each service date as free text. The acknowledgment is tracked like an attendance record, listing each department and the days of the month, indicating whether each department has submitted an acknowledgment for each day.
We collaborated with our IT development team to integrate this process into a Power BI app, making it accessible on the web so department managers can view their activity from anywhere. Additionally, we have included key performance indicators (KPIs) that display daily, LTD, YTD, and both current and prior year data by facility/department, allowing managers to view their variances compared to the previous year at any time.
Initially, we faced some resistance, primarily due to staffing concerns. However, after several months of testing, training, and educating each department both on-site and online, we have achieved an acknowledgment submission rate of around 85%, a significant improvement from the initial 5-10% over a year ago.
Does anyone have a solid charge reconciliation process for lab charges (hospital and outreach)? My organization recently transitioned to Epic and having issues w/the reports recommended by Epic.