The previous blog in this series explored how to effectively capture patient’s information at the front desk.
The next topic is charge capture—the process that physicians, other healthcare providers, and medical office staff use to record information about services provided. Once recorded, this information is translated into a claim and sent to third-party payers for reimbursement.
Charge capture is the process that physicians, other healthcare providers, and medical office staff use to record information about services provided. Once recorded, this information is translated into a claim and sent to third-party payers for reimbursement.
Insurance codes are used by health plans to make decisions about how much to pay doctors and other healthcare providers. Several types of code sets are used for different purposes during this process, including:
- ICD-10 diagnose codes – describe a patient’s condition or injury, as well as social determinants of health (SDOH) and other patient characteristics
- Current procedural terminology (CPT) and healthcare common procedure coding system (HCPCS) codes – indicate what actions were performed by the provider in administering care during an encounter
- Charge capture codes – connect physician order entries, patient care services, and other clinical items with a chargemaster code, a list of the prices for each service
- Professional codes – capture physician and other clinical services delivered and connect the services with a code for billing
- Facility codes or place of service codes – account for the cost and overhead of providing healthcare services, such as charges for using space, equipment, and supplies
Here are a few helpful tips to keep in mind to ensure your claim charges get reimbursed as quickly as possible:
Encourage clinicians and staff to enter all billing data into the electronic health record (EHR)
Ensure physicians sign off in a timely manner
Until an encounter is signed off in the EHR, you can’t start the billing process. A friendly reminder to providers to have them sign off can help
Save time with a mobile solution
Capture information about diagnoses and procedures faster and more accurately with a mobile solution that allows physicians and other staff to dictate notes on-the-go using a smartphone. Built-in voice dictation and transcription make it easier and more convenient to record details about patient visits and capture charges. Look for a mobile solution that integrates with your EHR
Increase accuracy with a certified code
Medical coding standards are increasingly complex. A certified medical coder is trained in these regulations and requirements and is better prepared to translate physicians’ reports into accurate medical codes
In our next blog, we'll delve into claims creation and scrubbing.
To learn more about practice efficiency and revenue optimization read our eBook “A Simple Guide: Practice Management and Medical Billing.”