Description

The chargemaster is a lynchpin within the overall revenue cycle.  Keeping the chargemaster up-to-date both for reimbursement as well as maintaining proper compliance is necessary.The chargemaster is a direct and indirect target of compliance for both governmental programs and private third-party payers.Chargemasters are complex and can be organized in different ways.Added to this overall mix is the continuing controversy over hospital pricing.A carefully crafted systematic process is necessary to audit a chargemaster to make certain that various concerns are met.The chargemaster must also be organized in a way that hospitals remain financially viable.

• How do you keep up with all of the CPT/HCPCS coding changes and their impacts on the chargemaster?
• How do you balance revenue optimization with maintaining compliance?
• What kinds of policy decision must be made with the chargemaster?
• Why is hospital pricing such a sensitive area?
• Should there be written chargemaster policies and procedures?
• Why are charges such a big deal?
• Why are the revenue codes sometimes ambiguous?
• How should supplies be handled?
• What about drugs and injections?
• What about nursing services?
• Should we be concerned about the cost report?
• Are there different kinds of chargemaster audits?
• How should clinical personnel be involved in a chargemaster audit?

Objectives of the session :

• To Determine if All Revenue Codes and CPT/HCPCS Codes Are Up-to-Date and Being Properly Reported
• To Understand Statutory Compliance Surrounding the Chargemaster
• To Appreciate the Contractual Obligations That Hospitals Have Concerning the Setup and Use of the Chargemaster
• To Have A Systematic Process to Review and Evaluate the Chargemaster
• To Discuss The Many Compliance Concerns Surrounding the Chargemaster Including Development of Pricing and Charges
• To Appreciate the Very Different Requirements Made By Different Third-Party Payers for Coding, Billing and the Chargemaster
• To understand how the Chargemaster affects and is affected by different payment systems including DRGs, APCs, MPFS and special hybrids.
• To Review Action Steps that Chargemaster Coordinators Can Take To Review and Update the Chargemaster and Make Improvements
• To Review Coding Changes for CPT, HCPCS, Modifiers and Revenue Codes

Agenda of the session :

• Overview of the Chargemaster Form, Structure and Contents
• Chargemaster Compliance Concerns
• Chargemaster Updating Review Process for 2017
• Chargemaster Policies & Procedures – Judgment Metrics
• Special Situations – Example and Case Studies
• Chargemaster Coordinator Action Steps