Charge Reimbursement Analysis

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I. Introduction A current and accurate Charge Description Master (CDM or chargemaster) is vital to any healthcare provider seeking healthcare reimbursement. Without the CDM the facility will not receive the proper payment including, • Overpayment • Underpayment • Under charging for services • Claim rejections • Fines • Penalties II. Description According to AHIMA, CDM is simply a master price list of supplies, devices, medications, services, procedures, and other items for which a distinct charge to the patient exists. It is the financial portion of a management system that tracks information about Lakewood Regional Medical Center’s charges for its services we provide to the patient. III. Challenges There are many facets to addressing the…show more content…
Plan a) Establish a policy and procedure b) Education and training for the CDM and all departments for the financial, clinical, and compliance importance 1. Ensure that every employee understands they affect the CDM process and the detail of what happens to their charge as it goes through the billing system c) Establish tracking and analysis systems to ensure accurate, appropriate and timely reimbursement. This includes current d) Ensure codes are current by picking an item at random to check for correct billing codes, department codes and procurement codes 1. e) Ensure CDM is thorough and is a true record of all services of products and supplies that are billed for and used within a hospital. This includes examples of correct mapping such as mapping a brand name to a generic. f) Plan for maintenance. This means periodic reviews based on coding or regulator changes as well as performing updates based on internal factors such as changing a product. g) Form a Chargemaster Compliance Committee including: 1. Finance 2. Compliance 3. Billing 4. Coding 5. Case Management 6. And “Chargemaster Coordinator” h) Submit a proposal to administration for implementation of an automated CDM system. An automated system will

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