Identifying Charge Capture Best Practices to Improve RCM

Though healthcare organizations consider revenue cycle management (RCM) one of the most important aspects of business, little research has been conducted on the front end of the financial revenue cycle: charge capture.

Since there are many different methods available, Ingenious Med commissioned a market study to determine the differences and similarities between acute care organizations using various charge capture methods. Only healthcare leaders with direct  or supervisory participation in the organization’s revenue cycle were considered, ensuring the most relevant sources of data.

In all, 104 healthcare leaders completed the survey. From this respondent pool, there were three main demographic takeaways:

  • Health Systems Dominant: The majority of respondents (74 percent) were from health systems or hospitals.
  • Title Balance: Almost half of respondents (46.2 percent) were from the c-suite. Over one-third of respondents (36.5 percent) had “revenue cycle” in their title.
  • Non-customer Pool: Only five respondents (4.8 percent) of the survey were active Ingenious Med customers.

To further analyze the study results, we identified top performing organizations based on six RCM metrics. Top performers maintain efficient revenue cycles with few denials and accurate coding that leaves low amounts of money on the table. Through analyzing top performers, we hoped to identify common traits and best practices that result in superior RCM.

6 RCM Metrics:

sixe best charge capture metrics

What We Assumed

Prior to the charge capture study, we proposed that:

  1. Healthcare organizations believed charge capture was important, but not always top of mind.
  2.  Paper charge capture would be considered an unsatisfactory method, while other forms would be neutral or good.
  3. Top performers would operate with different approaches and best practices than typical organizations.

Following the study, the data pointed to some surprising outcomes.

Breaking Down the Study Results

Of our three hypotheses, the survey results generally validated our propositions, but not completely. Most healthcare organizations believe charge capture systems are essential for improving RCM, yet many organizations are dissatisfied with their current systems and looking for better ways to manage missing charges.

capture charges send invoice

The Importance of Charge Capture

The surveyed healthcare organizations validated our first hypothesis with 78 percent of respondents characterizing charge capture as “essential” to their organization’s success. Yet, despite its essential nature, two of every five organizations (42.3 percent) reported discussing it amongst their leadership groups once a month or less. Considering the importance of charge capture to revenue cycle performance, we found this lack of ongoing discussion to be an area that, if changed, could quickly drive improvement.

Paper vs. Digital Charge Capture Methods

Contrary to our original hypothesis, the survey found that healthcare organizations felt widespread dissatisfaction toward all charge capture methods. Only 10 percent of respondents indicated that they would recommend their current charge capture solutions to other organizations, while more than half (52 percent) expressed frustration with their systems. To identify potential areas of improvement, we took a closer look at the types of charge capture systems most organizations use.

Of the respondents, a full quarter of organizations rely on paper records as at least part of their charge capture solution, while 50 percent of organizations rely solely on their EHR. Most respondents (83 percent) rely partly on their EHR but also incorporate additional solutions. Yet, even a combined solution can potentially cause unwanted problems.

Paper-only records are often unreliable due to lost charge slips and illegible documentation, but using the EHR for digital charge capture also has drawbacks. Large healthcare systems frequently use multiple EHR systems, leading to confusion or missing information. Conversely, independent practices and physician management companies may not be as tied into their EHR, creating inconsistent coding and documentation.

Despite the probability of errors in their current systems, 56.7 percent of respondents were unaware of standalone charge capture solutions, thereby suggesting that many organizations have not considered alternative platforms.

analytics chart

Best Practices of Top Performers

In addition to analyzing charge capture methods, we also surveyed the best practices that organizations are implementing for improvement. Of the respondents, more than half currently implement all identified best practices, which focused on analysis, training, and data transparency.

Consistent with our hypothesis, when organizations indicated the challenges they hope these best practices will solve, top performers had different priorities and concerns than other healthcare organizations.

Missing charges was the top issue for 61.5 percent of all respondents. However, since top performers and standalone charge capture users have seemingly resolved their common RCM problems, missing charges did not rank in their top three concerns.

Instead, top performers focus on:

  • Drawing greater data insights for analyzing physician productivity and location performance.
  • Decreasing charge lag even further, since they already have a healthy charge lag timeframe.
  • Providing physicians with transparent access to performance metrics. This offers a competitive incentive for physicians to outperform their peers, while also identifying those who may require additional training or guidance.
  • Improving integration with standalone charge capture systems built to integrate with EHR, while capturing, recording, and cross-referencing every charge.

To incorporate more efficient charge capture solutions, improve revenue cycle streams, and decrease charge lag, healthcare organizations should emulate the best practices of top performers in their own organizations.

And for those still struggling with missing charges, a standalone option might be better equipped to handle physician and back office workflows.

In future blog posts, we will take a closer look at top performers’ best practices for analyzing physician productivity and location performance, finding missing charges, and providing physician access to performance metrics.

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