Charge Reconciliation

dmay2

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

John.Settlemyer

Daily responsibility of each Operational Department (except for those that are under Charge Centralization)

mwindler77

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.

dmay2

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.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

reneebearden

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.

MaryEHowie

Is anyone willing to share their charge recon policy? 

kay.larsen@ah.org

What is the benefit to decreasing the hold period?  Our system is going from 5 days to 2. 

kay.larsen@ah.org

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

dseyfried

Here's ours. 

kay.larsen@ah.org

thanks, this is amazing!

stmsmith

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?

moinsf

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

jacobc@gcrmc.org

I just transitioned our hospital from AS400 to Cerner Rev Cycle. That was an experience. 

MaryEHowie

Thanks for sharing!

Nathan.Barnes

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

kay.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?

jbowman

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.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.