A healthcare organization’s revenue cycle can quickly become disorganized if there aren’t effective practices and procedures being utilized across all departments. A clean and methodical charge reconciliation process is an absolute necessity because it enables fast and accurate charge capture and the resolution of any pending charges. Because of how extensive and complicated a hospital’s revenue system can be, charge reconciliation must happen on a daily basis.
Many healthcare organizations are using outdated and archaic processes to capture and reconcile their charges. This most often leads to staff having to take up to several hours per day to generate and review reports for each patient that has visited. This directly influences your staff’s workload and the entire revenue integrity of a hospital.
hidden
What is Charge Reconciliation?
Charge reconciliation is the process of comparing multiple charges to the prices you are billing patients for.
Why Is It Important to Reconcile Charges?
Chasing around paper trails all day instead of investing in a proper charge reconciliation process can have a severe impact on your healthcare organization’s system. It causes staff to focus their time on clerical tasks that they often regard as unnecessary. These employees don’t have the bandwidth to analyze the information as often as they should, and they aren’t as meticulous as they should be. This has resulted in many organizations finding that they have around an overall 25% claim rejections rate.
All of this can lead to overcharging and undercharging. With overcharging, hospitals are automatically dinged as being non-compliant, which leads to more expensive costs and lost revenue that must be reimbursed to the payer. For example, if the government in a specific state was a payer, and a hospital used was found to be overcharging, that authority can legally charge and add on additional penalties, fines, and more.
Undercharging means that hospitals aren’t being paid sufficiently for their services. That revenue that is missed can’t go back into the hospital’s system as a future investment towards other systematic changes or labor.
How Often Do I Need to Reconcile My Charges?
Having a daily charge reconciliation process allows a healthcare organization to bridge the gap between themselves and providers, leaving little room for error in your revenue cycle. If you’re doing this every day, you won’t have to spend time retracing your steps when an error occurs.
With the correct software and staff training put into place, a daily charge reconciliation process will allow users to monitor all revenue that is deposited into a specific healthcare organization. The process will be able to identify any discrepancies quickly, that all payments are posted successfully, and that all insurance documents are reconciled.
What are the Benefits of Daily Charge Reconciliation?
If you have an automated daily charge reconciliation process, you’ll have decreased billing time, faster revenue collection, and improved preparation for audits. In a 2019 study, The Center for American Progress found that U.S. billing and insurance-related costs ranged from 2% to 5% for traditional Medicare and Medicaid to upwards of 17% for commercial insurers. The costly billing time that is involved in a manual process adds up quickly.
Decreased billing time results when your staff doesn’t have to spend extra time reconciling charges every day. By recouping that time, you’ll save on the added costs of administrative time and charge lag that could have ended up costing your facility thousands of dollars per incorrect bill.
Daily charge reconciliation helps to minimize the need for appeals by highlighting improper charges for both administrators and clinicians. Without having to go back and correct mistakes, you’ll charge correctly the first time and essentially eliminate incorrect bills, bringing revenue in the door at a much faster rate.
As the frequency and scrutiny of audits have grown over the past decade, so has the need to be prepared for them. And while healthcare audits can provide massive benefits for your hospital’s internal and external operations, you can run into frequent compliance issues if your charge reconciliation is off. Penalties for these issues can run into the hundreds of thousands, leaving your revenue integrity out of sync.
Should I Use Automation?
The short answer is yes, healthcare organizations can trust automated systems and should be moving their processes in a more advanced direction, but it takes proper training to implement an automated system well. On the front end, expectations should be set – a common misinterpretation of an automated system is that it can do everything without any direction. While automated software will handle the majority of the work for you, any new system has to be given directions of what to look for and what to generate in its reports, and humans will still have to sign off on and approve the work.
Who Should Be Involved in Daily Charge Reconciliation?
A common problem that arises is that without knowledgeable staff that has been trained in charge reconciliation software and knows what to look for in the case of discrepancies, mismanagement will happen. Without the properly trained staff, your automated software might as well be useless.
A dedicated superuser will need to be delegated to train and educate the clinical staff that will be using the automated charge reconciliation software. This person will need to be skilled in both clinical and financial departments, while also possessing in-depth knowledge of what cases a hospital handles and how their revenue flows throughout any given day.
What’s Next?
It’s critical to continue streamlining and honing all aspects of your revenue cycle. Look into implementing an automated daily charge reconciliation process through automated software and continue to train departments in these new programs.
Dig deeper with our episode on the biggest issues hospitals face with charge capture
hidden
Transcript
David:
Hello and welcome to the RevTech RX podcast! I’m your host, David Kosloski. And today we’re talking about the biggest charge capture issues hospitals face. Alongside me is the CEO of Avelead Jawad Shaikh; Laura Fox, Director of Revenue Cycle Services; and Greg Foreshey who is the VP of client success at Avelead. Well, everyone thanks so much for joining us today. Coming into Nashville. How were your travels?
Laura:
Great
Jawad:
Glad to be here!
David:
We’re in a cool place! Right here at the Sound Emporium in the heart of Nashville, which is pretty exciting! Did you guys ever think you’d be doing a podcast or a video with us in a sound studio?
Laura:
Absolutely not!
David:
We’re excited to talk about this really good topic related to biggest charge capture issues in hospitals. So to set the scene and kind of get things moving, why don’t we just start at the basics? What exactly is the charge capture process in hospitals?
Jawad:
Now it’s a great place to start because there’s so much confusion around revenue cycle it’s such a big topic. And then you get into revenue integrity. From collecting charges, patient registration, and then just dropping the bill. There’s so much stuff that’s going on. And it’s a great place to start. And then Laura probably can define exactly what part of that is charge capture. She’s the expert. So I’m gonna let her explain it.
Laura:
Charge capture is the process of capturing the services rendered by and documented by our providers. and it is a big challenge because our clinicians, they just want to take care of our patients. That’s their focus. They don’t want to worry about is these chargeable or not chargeable. So behind the scenes, we just have to make sure that there is someone that has an understanding of what is chargeable or not chargeable. It’s a big thing, big thing today especially with the crisis in healthcare right now. It just really needs to be noted and taken down [00:01:00] what is charge capture and who should bebe doing it.
David:
When you talk about it being a big thing, what are the repercussions of not doing charge capture appropriately? And what does that look like?
Jawad:
Well, margins and the way the hospitals operate are so tight right now. It’s the biggest thing, is how are you capturing everything that’s happening? And how is everything actually being generated in revenue for the hospitals. So as you can kind of see, there’s so much investment in healthcare right now and there’s so much money being lost because of missing charges and lack of charge capture. And, and the only thing just to add onto Laura’s definition to me charge capture sits in the middle of that clinical, and that financial world. And that’s what makes it really key. Cause everything’s happ ening in the hospital, some things are charged for some things are not and knowing what needs to be connected is where charge capture comes in. So it’s really the heart in the middle of a healthcare clinical and financial system.
David:
What are some of the biggest issues than just like getting straight to the root cause? Like what are the biggest issues that are currently happening in [00:02:00] today’s healthcare world?
Greg:
When it comes to charge capture, a big thing is that it’s just a lack of understanding that you have at these hospitals. Like Laura mentioned a clinician, they want to be a clinician. They went to school to provide patient care. They don’t necessarily care about charging. But it’s bridging that gap between financial and clinical, where they now have to understand it and they don’t have a choice. We’re going to clinically driven revenue cycle where their documentation is driving charges. And so that they have to be involved and they have to be engaged, even though it’s something that they probably didn’t go to school to for.
Laura:
They all want to know that the, what they’re providing is helping with the financial health of the hospital, they’re providing such good health care to the patient itself, but at the same time, they have to understand that that’s the financial health of their organization also that, everything that they provide has an of being chargeable or not chargeable..
Greg:
A big part of that too, is I always tell them, do you want to budget? Do you want to buy new equipment? Do you want to hire more staff? Then you’ve got to give two shits about charging appropriately. Because if you don’t, when you asked for this increased budget or you [00:03:00] asked for more staff, if you’re not generating revenue, it’s going to have the opposite direction. They’re going to want to remove staff and make you more lean and not buy that equipment that you’ve been asking for. So they have to care. Even if they might not want it.
Laura:
And it doesn’t have to be, not everyone has to care, but there has to be that team within each organization that understands what is happening in my organization. How is my system set up? How can I charge, how can I make this easier on my clinical staff to do their job every day and still have that financial outcome on the back-end. And that’s a big struggle now too, is getting that team that understands within our organization to help us get to that point. So that our clinicians don’t have to let that be their main focus, they can see the patient document on the patient and finish that work.
David:
It’s like, there’s a multiple questions that has come from that. So first one is. It sounds like there’s a team or system being in play, ? Like there is no, like it’s not a one department. It’s actually a cohesive group of individuals had to have to work on this.
Is that an [00:04:
00] accurate statement? Very much. And you, you talked about this one team though that has to work on this. They, it has to understand the system. It has to be able to understand how to train and what is that team?
Laura:
That team is generally going to be made up of your financial team, your IT team and your clinical team, there should be members from all of those teams within this group organization that can help put this together.
David:
Do most hospitals have that already?
Laura:
They have, I would think some semblance of it. But that’s where a lot of our struggle is is getting the right people in the right place. To help them do that work.
Jawad:
It adds on to the number one problem or challenge in, in charge captures people, communication or understanding it. Or understanding, what I’m doing here on the clinical side has the impact on the financial side. And that one team helps. As long as they have clarity in their roles, Hey, this is where I’m supposed to do this. What I’m supposed to do. That’s will make it more effective and that’s how you can fix some of those challenges.
David:
When you guys go to hospitals, are you typically seeing issues in charge capture in general? Like constant.
[00:05:
00] Laura: Yes. Yes. It is hard, very hard.
David:
Greg, what about your experience? I know that you worked at a hospital directly too for a while.
Greg:
Besides that they’re awful at it, but out of the hundred that I’ve been to, I haven’t met one. Maybe, maybe you have for you have, that has done it well is good at charge capture. That the main kind of scenario that I always see is what Jawad mentioned. You have a person who really understands the clinical side of it. You have a person who really understands the financial side of it. Do you have a person that understands both yet more times than not you don’t. So it has to be this team approach and you have to have people that understand each part and how they impact each other. And most times, at least the hospitals that I’ve been to that doesn’t exist..
David:
In hearing that it’s difficult, okay. So you’re, you’re talking about a lot of, a lot of people is what I’m hearing. Okay. That, that makes it harder or rather they’re not in sync. Okay. What, is there anything else outside of just these team or the people that make charge afters is genuinely difficult? Like what, there’s gotta be more than just like education or people. Like, what does that, what does that mean?
Jawad:
It’s the content of what they need to know or [00:06:00] not know. It’s some, a lot of it’s when we talk about communication, even a terminology for, so for example, we’ll get into like managing a chargemaster. So you’ll have a financial person that says that this thing is called a chest x-ray, and then a clinical person is looking for a TV. So just being able to communicate and understand clinical speak versus financial speak is, is a big deal. So we all get bills and payment in the mail and you can’t even understand what the bill says. That’s that’s the financial jargon or somebody just wrote that this is his code. And so understanding the process and then understanding the nomenclature or the content and being on the same pager, or to you use a sports analogy, just everybody’s not on the same playbook or using the same playbook? It’s a key part of it.
David:
One of the things that Laura had mentioned at the very beginning was related to physicians and they’re documenting . Making sure that they’re documenting correctly. In 2021, how has this difficult, like, is this like a hard task? Like, what am I missing?
Greg:
At least from my perspective, one of the biggest issues that we see is that not every department charges the same.
[00:07:
00] So you might say, this clinician, or this doctor uses an order that drives the charge. And that’s how you’re capturing charges for that specific department, but in therapy or in radiology, or, surgery, they don’t capture charges that way at all. They actually do do it very differently in the system. So you have complexities within each department within the same hospital that you can’t really standardize it and say everybody’s capturing charges at the same way, because they’re not each department is actually capturing them very, very differently. And, and as they moved from paper, Back in the day, you could say, we all have a paper checklist and it all looks the same, and we’re all going to give it to Betty Lou. And she’s gonna all key these charges in, and when we’re using the same exact charge capture process, cause we’re all on paper that’s went away and just the way they document and charge within their system now is so different within a hospital, within a department. And it just creates a lot of complexity that a lot of people don’t know. How you capture charges in radiology versus therapy versus surgery?
Jawad:
And just to kind of add onto that, this was a recent example where, we’re looking at surgery charges that are very expensive and being able to know what the [00:08:00] difference between a screw that costs 15 cents versus a screw that might cost a thousand dollars. It’s, it’s very significant. And it’s from a layman’s point of view, it’s it’s easy, but you gotta be very specific. Sure what you’re documenting, that I use this, or I use this material, which is very different. Pharmacy charges, for example, which is, Hey, I put in a pharmacy order, should I charge them or do I do a pharmacy charge when someone’s actually dispensing medication? Things like that.
David:
From the clinical perspective, what’s the gripe? Like where’s the, where’s the rubber meet the road in the sense of like, do they just not know, is it a frustrating part or they like, they, they care about patient experience. And patient care. So where are the, where are the problems accumulated? Is it because they’re just not communicating? Is it a tool issue? Is it a, is the program really complicated to work?
Laura:
Could be, that could be that they just don’t know where the finalization of the documentation is. And what is the last step I have to do to ensure that that charge drops? That’s really important when they go onto a system that they understand.
A fuzzy, what do I have to do as [00:09:
00] a clinician? I’m not writing on paper. Like Greg was saying, I’m not documenting on a paper where I can see everything I’ve written down. I’m in a checklist on the computer. And I have to complete that document. So that those charges came dropped. If that’s the way they’re dropping charges, again, it’s the complexity of how many different ways can I capture charges within even within a system you’re going to capture charges many, many different ways and understanding what’s my job. What’s my piece of the pie. When I’m in this system.
David:
So you let’s say, let’s say all this goes well. Okay. And you’ve created this great process and we’ll go into the details as to what kind of that process looks like, but let’s say it goes well, and everything’s done accordingly. Does it just only affect the bottom line for the hospital? Or are there other areas that this affects? Is it, I mean, does it affect patients? Does it affect like, is it just the dollar amount that gives the budget that were associated to.
Jawad:
Now there there’s so many different things, just even utilization. Is like, all right, how much water our staffing needs.
And so these [00:10:
00] metrics are used throughout an organization or a hospital organization as well.
Greg:
And the other thing I’ll add to, I mean, besides think about being a patient, and I know I had a CAT scan done and I know I had lab work done, and I know I had something else done and you actually get your item as itemization or itemized bill of services. And half of them were missing and you’re like, oh, I fairly confident I got put underneath the machine. I know that I went through that experience unless I was on really good drugs. And I’m just making stuff up. But , your bill doesn’t match that your item is itemized services provided don’t match that. So you have the real, I’m a real patient. This is my experience. I know I had this. And I, I asked you to show me everything that I had done and you can’t show me. Or my bill doesn’t match what services I had or didn’t have. And so just from a patient experience standpoint, consumers are more engaged than they’ve ever been in their own healthcare. Because they don’t really have a choice it’s coming out of their pocket a lot of times.
You don’t want to be the [00:11:
00] hospital that has the patient that said, you charged me for a million dollars of items that I actually. Pretty sure I went in there for an appendectomy that was probably $10,000. So, I mean, there’s that whole side of the coin too, that hospitals have to understand and be aware of.
David:
So it sounds like not only does affect a good charge capture process affect just your bottom dollar, the budgets for the departments, et cetera. But it also improves patient experience, which is a big deal. Is there any other entities that you can think of? An example, like does a CNO care about charge capture? Does it, does that medical record fall in line with them? I’m kind of feeding a little bit here, so I’m just curious, like.
Laura:
A lot of times it’s their staff. The most of the clinicians are a good portion of the clinicians probably report to a CNO in a hospital and they do care. They are the first one to tell you, though, I don’t care about charges. I care about patient care, but really they mean that when they’re with their staff, but then when they’re with the finance team, then they do care because they do want to hire more nurses.
So they do [00:12:
00] care. It’s just hard. It’s hard to cross that line between financing.
David:
And if it’s not done correctly, though, with the medical record being correct, and that would obviously be a problem for the CNO,
Laura:
that would definitely be a problem for everybody.
Greg:
duplicate charges we’ve seen which is kind of scary to think about, but you have a lot of times you have a patient that will see all these different charges or services on them and like, oh, actually that’s not the patient we saw at all. Somebody selected the mRN or the wrong encounter number, the totally wrong patient. And so as a CNO, you’re like, how the hell did that happen? But it’s because they don’t understand all the steps from A to Z that they needed to take to be able to document correctly charge, capture charges. Let’s start with picking the wrong patient is probably stepping, . .
David:
So let’s, let’s paint the perfect picture of what this really looks like. Are we using tools? Are we just having meetings? Are we, formulating a team and a group of people? What’s the process look like to make it to where it actually works in a hospital. If you were to give advice to a hospital and step in day [00:13:00] one, what are you telling them?
Jawad:
Yes. Yes. And yes. What you just said, what does that look like now? It starts with having good process and procedures in place and clear roles and responsibilities. If you kind of play that out and then it kind of gets into content. Making sure the Chargemasters are accurate, they’re maintained accurately. We were just talking about professional fees versus technical fees this morning. So they, even the administration. So they understand it as well too, because half the time they don’t understand the impact of what they’re doing clinically has on the financial side..
Laura:
Agreed with that. It’s not an easy process to set up and it’s, and it’s ever changing. That’s the other thing, Medicare is ever, ever, ever, ever changing on us. every quarter we get an, an update for Medicare, if something we can do now, or we can’t do. And so we have to stay on top of that. It’s not always just that one list. Here’s what you can do because it’s going to change. So you have to always keep up with it and make sure that you’ve built out your system correctly.
And you’re always educating [00:14:
00] on anything new that you’re doing are not going to be able to do in the future from a charge capture perspective.
Jawad:
We didn’t even mentioning compliance and regulatory requirements is one of the challenges as well.
Greg:
That’s a big one. When you were managing the large health system, how frequent did you guys update that?
Laura:
My goodness. Chargemasters for us grew daily when we were managing. I guess when I was managing the health care system, it depends on what hospitals are rendering, what services, you have to stay on top of it. It’s a big thing and it’s hard to manage it. It is hard to manage and the education that goes into it is just a huge part of it and the communication and making sure that the outcome of that education and communication is what happens. A lot of times, I mean, it’s repetitive, repetitive, repetitive that we have to go over and over and over.
Greg:
And something, as you were kind of talking through that, that I didn’t even think about until just now was even just like you’re updating all these policies, you’re updating it as, as Medicare has these updates. But what, what we’ve seen a lot recently is there’s been a lot of turnover in hospitals,
so you go [00:15:
00] through this education and you go through all this documentation and you’re perfect. Like you have every, that everything that you were supposed to. But how do you account for, we have a new ED director for a new surgery director that they didn’t give that information to. And they don’t have no idea what they’re doing. They don’t know how to capture charges. They don’t know how to reconcile. They know nothing about the process because no one passed on that information.
Jawad:
Or they’re doing it differently wherever they came from.
Laura:
I was going to say, oh, I was on this system when I was at that hospital. Now I’m on this one. How do I put those two in line? How do I get all my knowledge in line with my new system? It’s communication, communication, we just, we have to keep those lines open and just constantly talk about that financial health of the hospital, because that’s where we’re going to get the win-win is keeping that financial health as healthy as the patients that we’re trying to discharge.
David:
It sounds like the reoccurring theme is just, and same with any company. It’s just effective communication and making sure that, that there is a potential team that is helping distribute that communication. So our most hospitals, when you guys enter [00:16:00] them, are they aware of this problem or are they oblivious to it? Do they know that this is happening in their own house? Or is it just like complete shock? And then what are the results look like? Like what does that, what does that end up being? if you, Hey, we, we helped you build an effective charge capture process. This is what happened. This is why you need to do.
Laura:
They are not totally oblivious. A lot of times they know they have issues and that’s why they pull in companies like ours. And what they, what they’re shocked about is to the extent that they have it, because, they hire people who they feel like have the knowledge that they need to work their departments. And then, then you get a third party in there to help so long, what about this? What about this? What about this? and they’re like, oh wow. We haven’t thought of that. Yes. That is chargeable or no, that’s not chargeable. And to go through all those steps and then come out with a good process and a good set of charges. So it’s a big thing.
David:
What would you say the, like in the experience of your life, when a good charge capture process to a bad one, how much are we losing?
Greg:
Oh, God, you want the nice number or the mean number [00:17:00] in the middle? I would say on average, it’s about 10% of their overall clinical volume. So if I had a hundred a hundred orders within a lab department about 10 of those would be like a miss of some sort in their charge capture process. And when you start to talk about how that ties in with revenue, if you’re talking about 10% of a person’s gross revenue, And we’re talking to millions and millions of dollars, and that’s just that scale. That’s even for a baby hospital, that’s 25 beds, and then it just gets incrementally worse. As you have a 500 bed hospital, we’re talking $1 million on the low end, all the way up to $50 million on the large end of that. So, it’s a big impact for them.
Jawad:
I know HFMA has a number of like 1% of revenue, but what we’ve seen in our clients, in our data, it’s the revenue wise, not the clinical is it’s been around two or 3%, at least. That’s right. And that’s kind of on the low end.
Greg:
What we’re finding and think about your net revenue. $10 million hospital. One to 3% is, is a lot. And we’re talking monthly. We’re not talking about over the course of the year.
Laura:
We’re talking about gross revenue before we ever hit bottom line. we’re talking about getting that gross revenue up to par where it needs to [00:18:00] be on a daily basis. So that’s that monthly number that does come out is correct?
David:
. And then I’m going to go a little off script of what what can we wrote down, but we’re finding this missing revenue. That’s great. But I also have heard and through the grapevine that not all the times, is this an easy process? You’re talking about flipping over a hospital, upside down, reinstituting new processes, creating a team, new workflows. How much more work does this make for that 2%? A lot more work. Is it become easier? Does the PR does eventually become like advantageous for hospitals convert to this where everyone’s smirking. I’m not trying to downplay and I’m just curious, like, what does that effort look like?
Laura:
It’s a big effort. But it needs to be done. That’s the thing. And everybody recognizes that it needs to be done. There’s not a hospital out there that doesn’t know they need this. But again being able to budget that time for those people and budget, that money for what’s needed and possibly software that’s needed to get this done. It’s a big ask of a hospital to put this together, but do I think [00:19:00] on the back end that it’s gonna pay off? Absolutely. And it’s gonna pay off in a short amount of time. Not a five-year investment. It is a year investment. Usually I would say, because when you, when you’re looking to add at a high end 10% to your bottom line, you can get that sometimes within one department, if you revamped your Chargemaster and look at their process and make sure that that step A to step Z is completed appropriately. And then once you get that department, then you move to the other departments. you put that process in place and you make it work..
David:
When hospitals work with you, Laura, do they feel very calming when you enter the room? And they’re like, thank goodness. You’re here to help us through this whole entire process
Laura:
No,cause they know you’re here to point out something they can’t do. And so it’s always a negative start with such a good positive outcome. But you always have your negative Nellies who don’t want to participate and they’re the ones you usually need the most information out of, the people that don’t see the process and understand that there is an outcome to this that has such a positive outcome.
So,[00:20:
00] it happens. The positive part comes pretty quickly.
Jawad:
The only thing I would add to that, cause it’s a general issue. Are we creating more work? It depends on where they are. If they’ve been doing something manually and we can automate it, that makes their life easier. And in most cases, that’s it, or they’re not doing it all, then we’re, we’re adding a little bit of butter, but the issue is really not the actual work itself. It’s a general issue with everybody it’s changed. I’m just used to doing it this way. Even if there’s, my life is going to be much easier by doing this new technology or this new system that will automate the last stuff I’m doing manually. I just don’t like change and people just don’t like change. So that’s the hard part. It just getting them to change. Once they’ve accepted it in there, it’s actually working and they see the results. Then it’s much easier for them. It’s less work for them actually for greater bang for their buck.
Greg:
And it’s kind of crazy when we start to talk about like folks who aren’t involved in the process, you say, no, they, I actually met a department director today that prefers to have this stack of 50 papers as opposed to something that’s automated and it is on a screen.
And it’s just going to [00:21:
00] show him like three things. But it’s all about that change. They’re so in love with these papers that they’ve been using for 10 years, that’s the way we’ve always done it, that they don’t want to change this. Even if it’s going to save them two hours a day.
Laura:
A lot of security in that paper, it’s hard. It’s hard not to have that tangible thing in your hand. That says what I did today. Yep. I can prove to you. I did this where on the computer, I have to think. Hmm. How can I print this? at bottom line is going to prove it for you. Just relax. No, and let, let, let it flow.
Jawad:
That speaks to what we were just talking about before we started with the meaningful use EMR medical records. That was a huge change for the healthcare industry. Healthcare has got a lot to do to get technology advanced or to modernize. Where they’re very close to their, at least on the clinical side, but now we’re trying to push that on the financial and the revenue cycle side.
David:
you said one thing I want to touch on it. You said automation. It’s a buzz word right now in the industry. Everyone’s automating, there’s artificial intelligence. What, what automation is it that people can utilize in [00:22:00] the charge capture process?
Jawad:
There, there’s kind of so many things, what we tried, from at least from a product or solution perspective, I always look at, Hey, what’s the job to be done? What are we doing? We were just talking about if I’m a clinician or I’m a department director, I’ve got to go into my system, pull my reports of all my clinical activity that might be happened the previous day. Then I go look at all the bills that are generated and I’ve got these reports and I’m matching them up. I look at what needs to be automated, not as, Hey, what’s good automation, but what’s the job to be done. How do I help the end user do their job more efficiently with using technology or using automation? So we, we kind of focus on those types of things to say, Hey, this, if I’m doing this manually to reconcile, can I use technology or automation to do that for me? And then just spit out the gaps. So I’m only looking at those three things rather than those 50 pieces of paper.
David:
And the word on the street is that if you find things that are manual processed
that typically somebody will just [00:23:
00] tell you guys and you’ll make it right. So I guess I want to ask one last question, where do we think the future’s going? You say monthly things are changing? We talk about healthcare is ever changing but then we also talk about while it’s ever changing and evolving, it’s ancient. It’s all of a sudden, like it doesn’t make any sense how something can continue to grow every single month at the same time, still be left behind in the dust. And so many other things, where are we going to be in the next 2, 5, 10 years?
Jawad:
There’s two parts to that. One is we’ve got to use things like automation or technology to make the lives easier for the providers. And we, and we’ve got tools to do that and getting them to transition and change, to be able to accept it and then adopt it and utilize it. So that’s the first part, getting these systems in place, getting them educated and then making sure they’re using it. Then it’s what’s always changing is there’s always going to be changes. There’s always going to be a maintenance component to it. There’s always going to be a keeping it updated. The compliance or regulatory, those, those things. Like we went from ICD nine, ICD 10. There’s going to be always something.
Having a good [00:24:
00] base foundation of technology, but then a good way to manage and maintain that. Like managing the charge master, managing your daily revenue reconciliation. How do you do that? Make updates to that. If you have a new department that comes up or a new service line that started, how do you build that and make sure whatever’s being built in that charge capture process is updated accordingly. So it’s two fold to get built and then continually maintaining that system in an ongoing basis.
Laura:
Yep. I would 100% agree with that. Managing those changes are, that’s just one of the biggest hurdles that we face in healthcare right now is, is that total management of step-by-step.
Greg:
And the only thing I’ll piggyback off, both of them that I would add is once we have a good standard and we’re able to manage change and do all these different things well to, to me, you get to the point where you start to actually do some valuable things. Let’s start to say, now that we have all this data and we understand our charge capture process, and we feel really good about it, and we’re doing a good job with all our processes.
Then now let’s use [00:25:
00] that data and start to do some more meaningful initiatives. Now, how do we make this even more seamless for them? How do we make it an easier process for our staff? How do we spend less time doing this process across the board from A to Z? To me, once we start to get really good at this, then we can start to really have powerful data to support or create some new initiatives around it.
David:
that’s great. Well, this sums up the rest of the podcast episode. Thank you all so much for joining us here on the Rev Tech RX podcast, powered by Avelead. If you have any questions, feel free to shoot us an email. You check out our link at www.Avelead.com.