Reimbursement Analysis

Because the charge master is at the heart of every hospital’s and every practice’s billing and coding process, it must be analyzed and updated annually. However, charge masters are often overlooked and, once a practice has been in business for a while, it is easy to get complacent with your Charge Master.

But are you charging enough for your services?

If you are charging below what a payor is willing to pay, they will only reimburse the lesser charge amount. Our Analysts can do a comprehensive Charge Master Review. This includes taking a utilization report of the top 20-50 codes for the practice, and mapping those codes to all available fee schedules for the practice. We can then assess whether the Charge Master is an accurate representation of what payors are reimbursing you, or if there are changes that need to be made. We can assist in updating your system charges for you to ensure everything is up-to-date based on your current fee schedules. We recommend that fee schedules be loaded into the practice management system for tracking what payors are paying you, compared to your charge master. We can even assist with loading the fee schedules into your system. You could be losing cash by just not knowing if you are being paid your contracted rates.

We also can recommend if it is time for your fee schedules to be re-negotiated with our Contract Negotiation services. Having someone review your contracts on an annual basis is a critical task that most offices ignore.

Let us help you review your Charge Master and Fee Schedules!

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