Charge Capture in Healthcare

Charge capture is a critical process in healthcare finance, bridging the gap between the delivery of medical services and the financial reimbursement for those services. According to research conducted by the Healthcare Financial Management Association (HFMA), medical practices typically suffer an annual loss of more than $100,000 due to inefficient charge capture processes. This stark figure highlights the importance of optimizing charge capture in hospital billing, ensuring that healthcare providers get reimbursed properly for the services rendered to patients.

Charge capture is the process where healthcare providers record all services and procedures provided to patients for subsequent billing. An efficient charge capture workflow ensures healthcare facilities receive timely and appropriate payment for their services, mitigating the prevalent issue of charge lag—the delay between when a service is provided and when it's billed. 

What Information Do Doctors Need to Capture?

In an effective charge capture process, healthcare providers document several key pieces of information post-service delivery. This includes:

• Specific services rendered, typically denoted using Current Procedural Terminology (CPT) codes.
• Corresponding diagnosis codes, justified using International Classification of Diseases (ICD) codes, which validate the necessity of the provided services.
• Precise date and location of the service delivery.
• Any utilized supplies or medications during patient care.
• Quality-of-care information commonly known as the Merit-Based Incentive Payment System (MIPS).

This comprehensive and accurate documentation is crucial not only for billing but also for maintaining compliance with healthcare regulations and fostering quality patient care.

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Types of Charge Capture

Paper Charge Capture

Historically, charge capture was predominantly paper-based, involving the manual recording of services on paper forms, superbills, or charts, which were later processed by the billing department. Despite its simplicity, this method is susceptible to numerous challenges, including the risk of lost or incomplete forms, human errors in transcription, and consequent billing delays that result in charge lag and potential revenue loss.

Mobile Charge Capture

The creation of the smartphone ushered in the era of mobile charge capture solutions, marking a significant improvement over paper-based methodologies. This digital approach enables healthcare professionals to input service data directly into mobile devices at the point of care, offering multiple advantages:

• Reduced Charge Lag: Immediate data entry facilitates quicker billing, improving the revenue cycle.
• Increased Accuracy: Built-in validations in mobile systems help minimize coding errors.
• Enhanced Efficiency: The automation of data entry streamlines the billing workflow.
• Improved Compliance: Regular updates in mobile solutions ensure adherence to current coding and regulatory standards.

The migration toward mobile charge capture is motivated by the healthcare sector's imperative to bolster operational efficiency, curtail billing inaccuracies, and diminish revenue leakage. Mobile charge capture solutions enable healthcare establishments to navigate the billing process more accurately and efficiently, thus fostering a more financially secure and sustainable practice.

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How pMD^® Can Help

At pMD^®, we are committed to helping small practices streamline and optimize the patient care episode and the revenue cycle. Whether it's through providing specialist expertise, offering outsourcing solutions, or delivering our integrated billing services, our focus is to enable small practices to concentrate more on patient care and less on billing complexities. We can help your practice consolidate vendors, reduce costs, streamline workflows, improve patient care and satisfaction, and collect their maximum reimbursement more quickly.

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Not sure what a vendor could do to improve your behavioral health billing? Contact pMD^® for a no-commitment financial impact analysis by our team of healthcare RCM experts free of charge!

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