The hospital chargemaster is a critical revenue cycle tool that needs to be monitored and updated continually. Chargemaster inaccuracies can result in rejected claims, inappropriate reimbursement under OPPS, errors of omission, under- or overcharging and the potential for audits and fines due to compliance risks.
Chargemaster Analyzer is a valuable desktop solution that helps hospitals maintain an accurate and complete chargemaster for Medicare billing purposes and leads to fewer denials and more accurate outpatient reimbursement.
For Use By: Hospitals, Business
Features
& Benefits:
• Comparative charge, APC payment and fee data. Compares your charges with Medicare reimbursement and price and cost data for hospital outpatient services in your cost-based statistical area (CBSA) to help you identify potential additional revenue. It also helps you to justify prices established for procedures within the selected market.
• Best practices tool. Helps you find CPT® and HCPCS Level II codes that may be missing and identify additional revenue potential within each clinical department’s segment of the CDM file. surgery table included.
• Quarterly updates. Provide the latest CPT® codes, HCPCS Level II codes and payment rates in effect when you need them. Quickly update your chargemaster and avoid costly mistakes.
• Minimize denials and improve revenue cycle performance. Keep your CDM in check for inappropriate revenue codes, CPT® and HCPCS Level II codes and modifiers, and missing related procedures. Cross-references automatically identify which code(s) to use to replace a deleted code.
• Auto-analysis of imported CDM file. Increases productivity by automating the repetitive process of performing chargemaster code and data reviews, analysis and updates.
• All-inclusive CDM validation under outpatient PPS rules. Helps you analyze and validate your hospital’s chargemaster file against a comprehensive set of medical codes and data sets, hospital payment tables and coding relationships. Attain the most accurate and up-to-date review and analysis for Medicare billing and reimbursement purposes.
• Analyze and compare CDM data more effectively. Use the code view “Not Billable to Medicare” to instantly identify all codes that are not billable to Medicare under OPPS.
• CCI unbundled edits are highlighted to indicate which CPT®/HCPCS codes can be billed together. Highlights hospital outpatient CCI edits and code relationships. This will help you know which codes can be billed together with appropriate documentation, which are mutually exclusive and which require a modifier.
• OPPS payment lookup tables. Helps you locate hospital-specific APC payments and fee schedule amounts with ease.
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