Revenue Cycle management is an area that demands and receives frequent attention, but the surprising fact is that charge capture in RCM often goes unnoticed. Nevertheless, charge capture is a critical factor in the revenue cycle process, as dental practices risk losing millions of dollars in revenue if they do not accurately record data on the services rendered at their practice. “Revenue leakage” refers to situations where a healthcare provider has issued care and services to a patient, but does not receive payment.
Charge capture refers to the practice of documenting and recording the various services rendered to patients by the healthcare provider. These are then sent out to the insurance companies for reimbursement. It is one of the first steps in revenue cycle management, and any error at this stage can lead to claim denials.
Incomplete, un-billed or inaccurate claims submitted to the payer for treatments rendered to patients, result in the loss of more revenue than any other reason.
Challenges or Difficulties with charge capture :
Missing, Incomplete, or Inaccurate Documentation
While recording treatment details for a lot of patients, there is a huge chance for some details or information to go missing, be incomplete, or be inaccurate. This can become an obstacle to the effective functioning of your revenue cycle.
Not Documenting All Services Rendered
Practices, in their hurry because of the tight schedules, may at times forget or skip documenting some of the services provided, which may result in claim denials and payments going unpaid.
Sudden Patient Visits or Inpatient Consultations
Unexpected patient visits or inpatient consultations can create disturbances in the charge capture process.
Typos in Documentation
Typos in the information documented may seem like a simple mistake, but they can have a huge impact on your revenue cycle as they result in claim denials.
Long Documentation Gaps
While it is ideal to capture charges within 24 hours, coding staff frequently take too long to complete medical coding resulting in documentation gaps, in turn, prompting an increase in claim denials and redundant billing delays.
Benefits of having an effective charge capture system :
Identifying revenue leaks
An expert sharp eye can find any cracks in charge capture that would result in revenue leakage.
Timely submission of claims
Effective charge capture helps your practice submit a perfectly completed claim in the claims submission process well within the timely filing period.
Improved accuracy optimizes revenue
With an effective charge capture system helping your practice collect accurate and complete details of the services provided to patients, you can submit claims with the utmost accuracy.
Best practices involved in charge capture :
Eliminate legibility concerns
Place emphasis on accurate explanation of rendered services as they are provided to the patients and avoid any kind of legibility issues. This could be mistakes in the spelling and grammar.
Provide accuracy in coding
Emphasize coding accuracy so as to improve revenue and reduce the possibility of denials due to coding errors.
Set target goals
Make it your objective to collect payments within 24 hours, if not less, and strive to achieve the targeted goal. However, make sure that you collect the necessary data to identify if you have made any progress and make changes accordingly.
A system audit can be valuable as it enables your practice staff to concentrate exclusively on identifying the source of inconsistencies. It helps in uncovering erroneous billing practices and coding problems, both of which can contribute to accurate patient billing. This eventually leads to higher patient satisfaction.
Align your teams
For accurate and effective charge capture, it is important for your practice staff to work together – right from the providers to the staff, everyone should align. This helps in avoiding any kind of confusion that may arise between the providers and staff, thus helping in accurate and correct charge capture.