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Chargemaster Review
We have a dedicated team
of chargemaster experts with more than 10 years experience available to
evaluate your hospital’s chargemaster, make the necessary corrections
and provide education for the hospital staff that will enable them to
keep the chargemaster current based
on the
latest CPT-4, HCPCS Level II guidelines and Medicare OPPS regulations.
ACS consultants begin the chargemaster review and update process with an
extensive review of selected outpatient accounts, outpatient claim
rejections and corresponding billing forms such as the UB-04, Itemized
Statement and Electronic Claims Summary. These documents present the
total picture of an episode of care, beginning from the point of order
and continuing through billing and reimbursement.
To help the hospital update its' Chargemaster and comply with the coding
and billing requirements critical to optimal reimbursement, a complete
Chargemaster analysis with an assessment of outpatient coding is
available. The "scope of work" for a complete Chargemaster review will
consist of the following elements:
- Complete
Chargemaster Review for accuracy of CPT/HCPCS codes, revenue codes,
charge analysis, HCPCS description, modifiers and
billable/non-billable services.
- Staff Education
for OPPS Updates
Check accuracy of coding & billing practices in individual
departments.
Check the transfer accuracy of Chargemaster driven charges to the
claim.
- Identifies
erroneous or missing codes
- Review the
aspects of the chargemaster that affect reimbursement and data
quality.
- Core-based
Statistical Area (CBSA) Charge Analysis for every line item with an
assigned CPT or HCPCS code.
- Medicare Fee
Charge Analysis will be provided for every line item with an
assigned CPT or HCPCS code. Compares Medicare fee schedules with the
chargemaster charges.
- Deletes obsolete
items and recommends correct codes
Review the flow of data in the hospital for ancillary services.
Verify accuracy to department charge sheets.
Conduct department head interviews and staff education
- Review devices
for appropriate HCPCS level II code assignment and revenue code
assignment.
- Review the
supply chargemaster line item by item to identify any routine
supply, instrument and equipment charges and make recommendations
for cost incorporation.
- Provide chart
review along with the corresponding billing information.
- Provide
education to the staff members responsible for the chargemaster,
coders and department leaders.
- Provide a
summary exit conference for hospital leadership
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