Greg Cook, Director of Revenue Cycle Management
Why are the most important things so often the most difficult?
Facilitating effective charge capture is a tough task to accomplish in nearly any environment. When it’s done well, it’s something that just fades into the background, which is exactly how charge capture should work for clinicians. If you think about it, clinicians (and your healthcare organization) don’t get paid for completing charge capture, but they do get paid because they complete it. It makes sense, then, that everyone should strive to make charge capture workflows and their associated processes as seamless and straightforward as possible.
With that in mind, there are several key principles that should be employed whenever you are working on charge capture processes.
1. Don’t Reinvent. Do not seek to radically alter charging practices within your organization during your EMR implementation. This is a rare instance in which I advocate against using an EMR as a tool to facilitate major change, but in this instance the stakes are just too high and the benefits are rarely worth the effort and stress. Don’t mistake this principle for meaning ‘don’t eliminate, standardize, or reduce excess process.’ Consider the technological leap from cash to plastic that credit card companies guided us through – they didn’t alter the fundamental currency we use, they just reduced the noise (dollars and cents, and risk of carrying cash) we encountered every day. Once you and your clinicians have had a chance to settle into the new system and you are seeing expected charges and revenues, then you can begin executing plans to optimize, standardize, or alter your charging practices.
2. Make Everything the Same: On a macro scale, charge capturing for all clinicians within your organization should be as standardized as possible. Think of charge capturing hierarchically – starting everyone in your organization down the path of capturing the charges in the same manner. Then, when necessary, diverge the charge capturing process. An example I’ve come across is where one set of physicians uses an electronic ‘tick-sheet’ to capture their charges while another has their charges captured by documentation. Situations like this often happen when one portion of the software is better for accommodating one group of providers than another. It is important that you only diverge the charge capture process when necessary, as maintaining standardized charge capture workflows affords several significant benefits to both you and your clinicians:
3. Script the Steps: While you should try to standardize your charging processes as much as possible, there is no doubt that some portion of the charge capture process will be new or different to at least a few clinicians. In these situations, it’s very important to understand what steps in the process will be different, and to script those steps. It is critical that those affected by a new process have a step-by-step guide walking them through the change, as well as contact information for how to quickly get help if they get stuck.
4. Enable Transparency: Given the importance of charge capture on both clinician compensation and the organization’s revenue, it’s extremely important that the entire process, from end-to-end is transparent. Clinicians and managers should be able to obtain, on-demand, a report that shows all charges generated for a given time period or patient type; and this report should also show where charges are in the billing processes that occur after a charge has been captured. This empowers the clinician to verify the charges they’ve generated, and instills confidence that they will be compensated for the work performed.