What Are the Benefits of Charge Capture Audits

When managing revenue in healthcare, finding secrets is crucial to ensuring financial sustainability. Like explorers embarking on a search for treasure, healthcare businesses can embark on a quest to ensure revenue integrity by using audits to capture charges. This article will explain the essence of audits to capture charges, discover the hidden treasures in your company, and then outline how to implement them.

Defining Charge Capture Audits

Audits of charge capture are an organized method of reviewing healthcare providers at the time of appointment or scheduling, through to the point of reimbursement. The audits include a complete analysis of all the processes involved in pre-visit preparation, like patient eligibility and documentation for clinical services, Coding, charging, charge capture, reconciliation, billing, and reimbursement processes, to prevent the risk of revenue loss.

Approach to Charge Capture Audits

Audits of charge capture should concentrate on reviewing processes in place for the charging process. Below are some simple actions to assist you in creating your map of treasure:

Find areas of high risk. This could include departments that tend to delay the documentation process or the charging procedure. Mainly, focus on departments with the highest utilization of services or those with more complexity regarding services offered, including orthopaedics, cardiology, nephrology, pediatrics, radiology, surgeries, emergency departments, and more.

Review your charge capture procedure. Finding the best place to begin the charge capture process and creating a checklist for the process will not just guide you through the audit, but can also assist in identifying areas where there may be issues or failures. 

Conduct an audit early and frequently. Since the landscape of healthcare changes constantly, periodic audits are required to find problems that could be causing concern before they become serious problems and lead to revenue loss.

Conduct a root Cause Analysis (RCA). Once the audit has been completed, look at your findings and evaluate the effect of any identified problems. The process may involve involving the stakeholders in your finance and IT departments, billing, coding, and clinical departments.

Set out on a fresh course. Based on the insights gained from audits and RCA, chart a path to improve and implement steps to boost income streams, streamline processes, and enhance compliance security by conducting an audit re-audit.

Benefits of Charge Capture Audits

Charge capture isn’t an area where the company can guarantee it will go smoothly. The Healthcare Financial Management Association (HFMA) discovered that an average medical practice is losing around $125,000 each year because of ineffective charge capture practices. Furthermore, HFMA reported that on average, hospitals are losing up to 1 percent or more of their charges through leakage, which results in thousands of dollars in revenue lost. There are four primary advantages of conducting audits:

Revenue optimization: Healthcare organizations can increase their revenue stream and stop the loss of money by finding and correcting errors in charge capture procedures.

Audits for compliance with the law: Charge capture audits help ensure compliance with regulations and guidelines for payors, reducing the possibility of violations in compliance and the associated penalty.

Efficiency of operations: Streamlining the process for capturing charges by conducting audits increases operational efficiency, reduces administrative burdens, and improves overall efficiency.

Better patient care: Achieving accurate charge capture will ensure that you receive the right amount for the services provided, which allows health professionals to keep top-quality standards for patient care, with no financial limitations.