Top 5 Mistakes in Claims Management – And How to Avoid Them
Claims management accuracy and efficiency are crucial for hospital billing, accounting and finance professionals. However, common missteps can cause...
By Sherry Nardi, Solution Strategy Director, FinThrive
Maintaining a healthy chargemaster is a key component to preventing revenue leakage but can also be labor intensive and time-consuming. With thousands of ongoing line-item updates, limited staff and compliance issues coupled with price transparency requirements, what does it take to maintain compliance while protecting revenue?
Think of maintaining your chargemaster like getting a regular check-up for your body. With consistent and regular exams, you can ensure that you’re accurately capturing CMS updates, new procedures, services, supplies or drugs. As a result, your organization can:
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| Remain compliant even with ongoing regulatory changes |
Identify areas of potential risk |
Educate staff and develop a proactive plan to defend your CDM |
FinThrive Revenue Integrity has identified four best practices to help your team keep your chargemaster healthy and optimized.
- Review your CDM at least quarterly
At a minimum, the CDM should be reviewed quarterly to ensure that you capture all CMS or fiscal intermediary updates, new procedures, services, drugs and supplies, in addition to any pricing changes. It might come as a surprise, but an estimated 60 percent of chargemaster items are either inaccurate or missing. With such large discrepancies, payer denials and compliance risk can become an issue. - Train your team in the “three Cs”
The team responsible for maintaining the chargemaster should follow the three Cs: correct, complete and compliant. Verify with your staff that they understand the descriptions, charges and codes relevant to their department. - Leverage online reference tools
Regularly communicating all changes and/or updates to the appropriate department staff and physicians is essential to an accurate and efficient revenue cycle. Consider upgrading to modern CDM maintenance technology to ensure that your CDM is regularly maintained. In addition to CDM technologies, FinThrive also offers an online reference tool, FinThrive Knowledge Source. It quickly and easily provides current regulatory guidance for all areas within the revenue cycle continuum. With more staff working remotely, a web-based solution is a cost-effective way to ensure that everyone has access to the most current and compliant information. - Focus on operational integration
The CDM touches all areas of the revenue cycle, so building a strong, integrated structure is imperative. Both departmental and operational managers play a key role in helping the charging process by correcting coding problems at the source. The chargemaster is at the heart of a healthy revenue cycle, serving as an organization's starting point for billing patients and payers. FinThrive’s CDM Manager chargemaster technologies are complete cloud-based platforms that analyzes your complete CDM for compliance changes and makes recommendations for updates, which ultimately aids in the mitigation of inaccurate charging. It also provides benchmark pricing for more than 475,000 line items via our best practice CDM catalog.
With constantly changing charge items and regulations, healthcare providers need an accurate and compliant source of truth that generates correct charges and defensible pricing. A well-designed and maintained CDM can improve staff productivity, reduce claims and line-item denials, and minimize reimbursement and audit risks.
Ready to maintain a healthy chargemaster? Learn more about how FinThrive CDM Manager solutions can help your organization keep your CDM correct, complete and compliant.
About the Author
Sherry Nardi
Solution Strategy Director
Sherry has over 25 years of healthcare experience in revenue cycle operations, sales and supply chain roles. She provides charge integrity solution strategy expertise to providers in partnership with FinThrive Customer Success Management, with a focus on web-based solutions. Sherry works closely with Product Management to ensure our charge integrity solutions are continually meeting the needs of our customers and are addressing healthcare industry changes. Prior to joining FinThrive in 2000, Sherry oversaw Supply Chain Purchasing/Contracting at Children’s Healthcare of Atlanta.
