LUTZ BUSINESS INSIGHTS
why do a chargemaster review?
paul baumert, healthcare consulting shareholder
How pricing is set for a healthcare organization can have a significant impact on its financial performance. If individual charge items in the chargemaster file contain errors, payment for services could be wrong or denials can occur. These are two critical reasons why it’s important to routinely review the chargemaster file.
The chargemaster file is a main component in any third party compliance review, since the healthcare organizations’ reimbursement originates from individual charge items. Ensuring accurate code descriptions and pricing for individual service items is paramount for price transparency. Below are additional reasons to conduct a chargemaster review:
- Keep up-to-date CPT/HCPCS Codes
- Correct Revenue Code assignment
- General Ledger/Department assignment and mapping accuracy for proper cost report preparation
- Remain compliant with billing and coding for services
- Ensure accurate Charge Capture for services performed
Maintaining an accurate and compliant chargemaster file is an on-going process. Periodic internal and external comprehensive reviews are essential duties of the revenue cycle team. Additionally, to properly monitor and update a healthcare organizations chargemaster file, policies and procedures are critical to ensure on-going changes are made. This will help prevent errors in payment and compliance related issues that can arise with incorrect/outdated chargemaster files.
ABOUT THE AUTHOR
PAUL BAUMERT + HEALTHCARE CONSULTING SHAREHOLDER
Paul Baumert is a Consulting Shareholder at Lutz with over 20 years of experience in accounting and consulting for healthcare and nonprofit industries. He specializes in the areas of financial management support services and reimbursement analysis.
AFFILIATIONS AND CREDENTIALS
- Nebraska Society of Certified Public Accountants, Member
- American Institute of Certified Public Accountants, Member
- Healthcare Financial Management Association, Member
- Certified Public Accountant
- Fellow of the Healthcare Financial Management Association
- BSBA, Creighton University, Omaha, NE
- Elkhorn Public School Foundation, President
- Iowa Healthcare Financial Management Association, Past President
- Nebraska Society of Certified Public Accountants Legislation Committee, Chairman
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