A Five-Step Audit for Peak Charge Capture Performance

The financial health of a healthcare facility depends on its ability to generate income through efficient charge capture, which is the process of charging the payer or patient in exchange for an item, service, or supply. The charge capture process is a part of every aspect of the health system, including the patient’s admission and performance. Still, many healthcare facilities do not ensure optimal performance in charge capture. An often-ignored and underutilized method of improving the efficiency of charge capture is to perform audits.

Auditing the charge capture process takes an in-depth look at every aspect of charge capture, revealing the root causes behind costly mistakes or inefficient processes so that the financial team can resolve issues and restore integrity to revenue. An effective charge capture audit strengthens revenue streams and eliminates charge losses

Get to the top of your performance through the five-step Steps to Charge Capture Audit Process

Charge capture auditing amplifies every phase of capturing charges, allowing the financial managers to spot problem areas costing the health system precious dollars. With an objective in mind, the system is in the process of establishing its auditing program following the five steps below:

Step #1: Set the Standard

In the initial step of the auditing process, the auditing team has to be aware of the requirements of the procedure, policy, or procedure that they are performing audits on (e.g, that of the healthcare system’s CDM maintenance process).

Step #2: Measure Current Practice Against the Standard

The auditing team determines and gathers the relevant data to evaluate current practices. The auditor should consider the quality of the data and its volume when deciding on the most appropriate data. By setting the requirements for data at an early stage, health systems can gain reliable information about how they code medical records during the initial audit and avoid needless repeat audits.

Step #3: Compare Standard Results with Practice Results

In the final step, the auditor can conduct the audit and compare the results against the data and standards of steps 1 and 2 to identify any discrepancies.

Step #4: Change the Practice to Best Practice

The auditing team has found issues with charge capture. The goal is to pinpoint the root of the problem so that the leaders can fix the mistakes.

Step #5: Re-Audit

When leaders have made procedures and process changes in response to audit findings, the auditing group should re-audit to determine whether the changes have resolved the initial problems. 

Conclusion

Charge capture is crucial for the survival and growth of the health system. Through a well-designed charge capture system, the organization can manage risk more effectively financially and gain the resources to offer healthcare. 

Utilizing the five-step audit process described above, organizations can provide medical care to those in need and maximize earnings from every service and process. Audits on charge capture can uncover opportunities to eliminate the cost of errors, improve accuracy in charge capture, and ensure that the revenue stream is flowing again.