Potential Benefits to You
- Complete and accurate assignment of both ICD-9-CM diagnosis and CPT procedural codes
- Facilitate linkage between the code sets, and assure that all compliance guidelines are met
- Reduction in lost or late charges
- Improvement in timeliness and appropriateness of reimbursement
- Reduced exposure under Medicare’s compliance guidelines
Charge Process Analysis
Poor charge capture processes are responsible for the loss of millions of dollars in revenue every year. The consequences of inadequate charge capture processes include:- Lost billings due to process collapse
- Denied claims due to inadequate linkage of diagnosis and procedure codes
- Extension of the reimbursement cycle
- Excess administrative costs and reduction in time available for patient care
BKD Health Care Group performs the following procedures as a part of our charge process analysis:
- Assess the hospital’s denied claims from Medicare
- Compare billed services to the medical record documentation to determine if all billable services have been charged and if all services billed are documented appropriately
- Recommend the addition of charges if it appears that a service is being performed and the service is not currently a part of the CDM
- Review diagnosis, procedure, and evaluation and management (E&M) coding for hospital services
- Review the Medicare bundling/unbundling of CPT/HCPCS codes using the correct coding initiative and outpatient claim edits (OCE)
- Review itemized statements, UB-92s and remittance advices for each individual record sample
- Assess the hospital’s charge ticket design
For More Information
Contact your BKD advisor or:Ann King
BKD Health Care Group Leader
800.581.4290
