Chargemaster Maintenance and Review
If your Charge Description Master (chargemaster) is not up-to-date, then you're not accurately reflecting to the payer world what you're doing clinically. It's challenging to keep the chargemaster accurate because the rules are continually changing: The Centers for Medicare & Medicaid Services (CMS) make quarterly changes to the rule sets, hospital clinical departments make changes throughout the year, and third party payers sometimes come up with their own rule sets for different service areas that they want to track and bill differently than Medicare. It's very difficult to keep up with all of those changes.
The second big component of risk is whether your chargemaster is complete. Completing a chargemaster review is time-intensive and the various clinical departments don't always understand the importance of a complete and accurate chargemaster. In smaller hospitals, there often isn't staff dedicated to maintaining the chargemaster database.
Accordias can help you to make sure there is a process for ongoing comparisons of your chargemaster against the CMS rules and by regularly updating your chargemaster to reflect services offered at your facility. It's critical to focus on the chargemaster just as you focus on the revenue cycle.