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Clinical to Charge Capture Reconciliation Services

“A huge win for us is that the clinicians on our team are more aware, more cognizant of the charges and the impact to care and workflow that presents. It’s a true example of clinical, operational, and financial partnership to deliver excellent care to our patients”

Director of Wound Healing and Hyperbaric Center

In today’s healthcare environment of relational databases, the integrity of charge capture no longer resides solely in the chargemaster (CDM). Clinical orders flowing to the CDM to create a charge is no longer a linear function. Many different steps through the patient’s journey affect the charge such as fee schedule, patient location, cost center, account type, and even the user login identification. All of these factors impact a charge as it flows through the healthcare system.

Ensure Optimal Charge Capture from Beginning to End

Many times during an EHR conversion, clinical to charge pathways are defined and tested. However, most organizations “set it and forget it”, neglecting to periodically test to ensure the links along the pathway from order entry to a charge landing on a bill are still functioning correctly. Just as you audit your CDM to ensure accuracy on a scheduled basis, you also need to reconcile the clinical and charge capture systems.

Craneware’s Clinical to Charge Capture Reconciliation Service assists health care providers validates the links and triggers between and order or procedure in clinical systems to the corresponding charge reported on a patient account. This service also identifies:

  • Entries in the clinical system that have no charge associated
  • Entries in the CDM that have no charging mechanism in the clinical system
  • Incorrect revenue allocation

Expertise to Assist with Reconciliation Projects

Craneware experts know both the CDM and clinical systems to facilitate the audit process between the revenue and IT teams. Our consultants have expertise in both revenue integrity and EHRs, such as Epic, Cerner, and MEDITECH.

Our unique approach focuses on revenue recognition, reconciliation, and realization to support successful EHR conversions, upgrades, system mergers, and ongoing EHR optimization. This success provides not only enhanced revenue but also sustainable revenue integrity processes to keep your margins healthy.

Let us assist your dedicated team in identifying areas to improve revenue for your organization.