Charge Reconciliation

dmay2dmay2
in CHARGEMASTER & CHARGE CAPTURE
How does your organization handle Charge Reconciliation? Is the responsibility of the dept. or does your Revenue Integrity department reconcile?

Comments

  • John.SettlemyerJohn.Settlemyer
    Daily responsibility of each Operational Department (except for those that are under Charge Centralization)
  • mwindler77mwindler77

    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.

  • dmay2dmay2
    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.
  • Valerie.rinkle@valorizeconsulting.comValerie.rinkle@valorizeconsulting.com
    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

  • reneebeardenreneebearden
    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.
  • MaryEHowieMaryEHowie
    Is anyone willing to share their charge recon policy? 
  • kay.larsen@ah.orgkay.larsen@ah.org
    What is the benefit to decreasing the hold period?  Our system is going from 5 days to 2. 
  • kay.larsen@ah.orgkay.larsen@ah.org

    The above should read going from 5 days to 4 days.

  • dseyfrieddseyfried
    Here's ours. 
  • kay.larsen@ah.orgkay.larsen@ah.org

    thanks, this is amazing!

  • stmsmithstmsmith
    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?
  • moinsfmoinsf

    We will be going live with Epic in August.  Is there anyone else who has implemented Epic?  Thanks in advance!

  • jacobc@gcrmc.orgjacobc@gcrmc.org
    I just transitioned our hospital from AS400 to Cerner Rev Cycle. That was an experience. 
  • MaryEHowieMaryEHowie
    Thanks for sharing!
  • Nathan.BarnesNathan.Barnes

    Does anyone have any Epic policies they would be willing to share?

  • kay.larsen@ah.orgkay.larsen@ah.org
    https://forums.nahri.org/discussion/comment/230#Comment_230

    I know your pain.  Even after 7 years, I still mourn the loss of my AS400 queries.  Maybe we could develop a support group?

  • jbowmanjbowman
    https://forums.nahri.org/discussion/comment/115#Comment_115

    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.

  • Valerie.rinkle@valorizeconsulting.comValerie.rinkle@valorizeconsulting.com

    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.

  • ShawishihaynesShawishihaynes

    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.

  • akhanakhan
    https://forums.nahri.org/discussion/comment/467#Comment_467

    How is your team monitoring these charges? Can you share please?

  • hdubois@lifespan.orghdubois@lifespan.org

    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.

  • kay.larsen@ah.orgkay.larsen@ah.org
    https://forums.nahri.org/discussion/comment/433#Comment_433

    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.

  • ramcoro00@gmail.comramcoro00@gmail.com

    Hi!

    I went from AS400 to Cerner and now I'm in Athena Health. Is anyone familiar with this platform?

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