With intensifying pressures to grow revenues while managing costs, health systems and physician practices are renewing their efforts to optimize their revenue cycle management (RCM). When organizations fail to capture charges at the point of care, the impact ripples out to the business operations of the entire organization, and creates a missed opportunity to maximize revenues, reduce physician burden, and enhance business performance.
Charge capture approaches vary
There are a few different approaches to capturing charges:
- EHR systems: EHRs can perform basic charge capture, but often can’t capture complex charges and are not available to physicians on the go at multiple care delivery locations
- Batch processing at the end of the day: This approach offers the potential advantage of not interrupting the patient care workflow, but usually suffers from missed charges and lower accuracy, especially with more complex
patients with multiple diagnoses and CPT codes
- Charge capture at the point of care: Purpose-built third-party solutions enable charge capture immediately following care delivery regardless of location across the care continuum. This provides the greatest accuracy and least opportunity to miss charges.
The first two methods aren’t always well-connected to what’s happening at the point of care. The farther a clinician gets from seeing a patient, the greater the risk for error – and lost revenue. That problem is compounded when you can’t capture charges at the point of care beyond the hospital into settings such as skilled nursing facilities and home health visits.
Three advantages of charge capture at the point of care
1. Drive more revenues. The key advantage of capturing charges at the point of care is that it prevents under-coding and missed revenue opportunities and therefore drives more revenue. Having clinicians document charges quickly also enables you to speed up reimbursement turnarounds. Combined, these benefits strengthen revenue integrity.
2. Improve productivity and performance. But higher revenue capture isn’t the only advantage. When your physicians correctly enter charges for their patients, you can also more accurately monitor their performance and productivity. A purpose-built solution enables you to combine that real-time charge data with length of stay, readmission and other data and enable each individual physician to benchmark their performance against their peers. You can also compare one medical group or region against others across the organization. When physicians themselves have entered the data, they are far more likely to view it as valid, which promotes buy-in and drives a greater awareness of their personal performance and its impact on patient care.
3. Increase physician satisfaction. At the point of care, physicians are already in a clinical, detail-oriented mindset. They are focused on the patient’s diagnoses and the care they just delivered, so they can move quickly from entering clinical data to entering the appropriate diagnostic and procedure codes. Having mobile, easy-to-use technology facilitates that data entry regardless of where they are providing care – including in a skilled nursing facility or outpatient setting.
The solution should be easy to use and intuitive, with pre-populated menus and minimal clicks to reduce the time and effort needed for charge capture. Ideally, it should also facilitate communication between coders and clinicians to quickly fix any coding issues or errors. Finally, it should alert administrators to physicians in danger of burning out from overwork so they can intervene proactively.
What this means for your healthcare organization
The benefits of a solution developed specifically for capturing charges at the point of care extend far beyond revenue cycle management. It enables both medical and administrative leaders to have the data they need to set KPIs and monitor physician performance in real time. They can get insights from across the entire organization while also drilling down to the individual physician level to get to the specificity needed to identify outliers and reward high performers. At the same time, you can also quickly spot physicians who might be at risk of burning out.
This business intelligence data can help you establish a more solid foundation for downstream decisions involving staffing, capital investment and other aspects that keep your operations in the black. Rather than being limited to a view of charges within the four walls of a hospital, you can track charge capture and revenues post-discharge and into the post-acute care arena, where a growing number of care services are provided. And in a world of growing value-based payment models such as bundled payments, this visibility into performance is no longer nice to have – it’s essential.
How do you compare?
How are your charge capture processes measuring up in this environment? Calculate the potential value for your healthcare organization using Ingenious Med’s Revenue Optimization Calculator. Our tool shows the impact of having point-of-care charge capture on the revenue cycle with just a few simple inputs. You can also download a more detailed report that provides additional insights into why Ingenious Med’s point-of-care charge capture solution can improve revenue cycles for your organization.