Sustaining Your Hospital as Payment Methodologies Shift
As the focus in healthcare shifts from “revenue cycle” to “value cycle” how do you sustain your hospital? An accurate, complete, up-to-date, and compliant CDM guides you in discovering, converting, and optimizing your organization’s resources for the good of the community you serve. So how do you make sure your old reliable CDM is ready for the challenge of sustaining your hospital in an environment of rapid change and value focus? Check out these tips for establishing regular and ongoing communication between the financial and clinical areas of your CDM.
- Schedule regular individual clinical leader sessions (annually/quarterly)
- Provide detailed CDM for each department, with 12 months of charge line utilization
- Identify unused charge lines and determine why
- Deactivate charge lines with no usage/anticipated usage
- Review all CPT/HCPCS codes currently assigned
- Review revenue codes
- Review modifiers if attached to the charge line
- Review compliance guidance for the charge CPT and/or description
- Review the services provided in the department
The most important avenue for maintaining an up-to-date and complete CDM is communication with departmental leaders so that they become knowledgeable and accountable for the accuracy of their charge lines. If your CDM is a little sparse, not quite ready to be your hospital’s linchpin to sustain it during these times of shifting payment methodologies, don’t hesitate to ask for help.