Charge Lag and Reconciliation in Healthcare Billing

Understanding operational terms like charge lag and reconciliation is crucial for ensuring the financial health of medical practices. Both elements play pivotal roles in the revenue cycle management (RCM) process, influencing the efficiency of hospital billing and medical billing services. 

Charge lag, a common term in hospital billing and medical billing services, refers to the delay between the time a healthcare service is provided and the time the charge for that service is entered into the billing system. This delay can significantly impact a practice's cash flow and revenue cycle management.

Common Causes of Charge Lag

Charge lag can stem from several sources, each contributing to delays in the billing process. Some of the most common causes include:

  • Manual Charge Entry: Relying on paper-based systems or manual entry of charges can introduce delays, as the information must be collected, organized, and then manually entered into a billing system.
  • Incomplete Documentation: Incomplete or inaccurate documentation of services rendered can lead to delays as additional time is needed to verify and complete the charge information.
  • Communication Gaps: Miscommunication between clinical staff who provide the services and administrative staff responsible for billing can result in missed or delayed charge entries.
  • Complex Medical Services: Complex or multifaceted medical services may require more detailed documentation and verification, leading to longer processing times.

What is Charge Reconciliation?

Charge reconciliation is the process that ensures every service provided to a patient is accurately documented and billed. This critical step in medical billing services involves reviewing and verifying the charges entered against the patient's medical record and the services documented by healthcare providers. Charge reconciliation aims to identify and correct any discrepancies, missed charges, or errors, ensuring that the practice is appropriately reimbursed for all services rendered.

How Modern Charge Capture Can Help with Reconciliation

Modern charge capture technologies offer a solution to many of the challenges associated with charge lag and reconciliation. By leveraging these advanced tools, healthcare practices can streamline their billing processes and improve financial outcomes. Here's how:

  • Automation and Efficiency: Modern charge capture systems automate the process of entering charges, reducing the reliance on manual data entry and minimizing the potential for errors. This automation helps in significantly reducing charge lag.
  • Real-Time Documentation: With mobile charge capture solutions, healthcare providers can document charges at the point of care, ensuring that all services are captured accurately and in real-time. This immediacy aids in closing the gap caused by charge lag.
  • Integration with EHR Systems: Many modern charge capture systems are integrated with Electronic Health Records (EHRs), facilitating seamless data transfer and documentation. This integration supports thorough and accurate charge reconciliation by ensuring that all documented services are matched with corresponding charges.
  • Analytics and Reporting: Advanced charge capture solutions provide analytics and reporting capabilities that allow practices to monitor and analyze charge entry and reconciliation processes. These insights can help identify patterns in charge lag and areas for improvement in the reconciliation process.

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.

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!

To find out more about pMD's suite of products, which includes our charge capture and MIPS registry, billing services, telehealth, and secure communication software and services, please contact pMD.

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