Medical billing can get very complicated and lengthy. Even if it is just for a patient with a small problem that only took a few minutes to be addressed, creating the bill for that service and forwarding it to insurance companies or any other paying service is a different matter altogether. With lengthier procedures that need many follow-up sessions and ongoing treatments, it can be tedious to manage the billing process.
This is why hospitals and even smaller clinics have specialized billing staff who manage this process exclusively. All the documentation produced from a medical procedure must be processed accurately for the job to be completed. This order processing often has many other functions attached to it depending on the service rendered, and the regulations governing healthcare providers.
Many healthcare providers also have a specialist in medical coding who is part of the billing process. This person’s job is to ensure that all the processes during the treatment journey have been assigned the correct codes so that they can be processed by the payer without unnecessary delays. This is often such a time-consuming and complicated task in itself that many hospitals and clinics outsource this role to a third party. Larger hospitals may have an on-site team that is handling this process.
Charge entry is the process of assigning a proper value to a patient’s record based on the medical codes associated with their treatment and the fee schedules that apply. The amount of money that the healthcare professional receives for his or her services depends entirely on how accurately the charge entry process is executed and errors in this part of the job could lead to not only delays but also claim rejections.
Hospitals across the US face millions of dollars in losses just because they are unable to properly document patient information and properly forward this to insurance companies and other institutions that provide medical coverage. Accurate charge entry helps to optimize this process and effectively implement charge capture. It requires good communication and collaboration between coders and charge entry specialists to ensure long-term success.
What Charge Entry Covers
Different hospitals and clinics have different methods in which they bill the patient. Depending on the kind of treatment that the patient is getting, how that treatment is being administered, and whether or not the patient is eligible for any extra coverage or is subject to any additional charges, the way that the charge entry is executed will vary.
Services at Santiam Hospital, for instance, are charged differently depending on whether the patient is an inpatient or outpatient. This could affect how much they are billed and what additional services will need to be included in the bill.
For instance, two patients at the same hospital receiving treatment for the same problem can be billed very differently depending on who is providing the payment for the process and what kind of medical coverage they have. In most cases, charge entry medical billing will cover things such as the date when the services were rendered, doctor information, service location, and admission date. It also includes information about the referrals or authorization and specifics of the treatment costs.
Value Of The Charge Entry Process
Collecting patient information and compiling the billing information is tough work. It takes time and there is a lot of room for error. One of the main reasons why healthcare providers seek specialists in this department is to make the process of collecting and compiling data quicker and less prone to error. Having the right data to work with is the first step in ensuring that the rest of the process will follow through as intended. One of the most expensive problems for healthcare providers and patients alike are claim denials and having better billing processes help to reduce this burden. Charge entry specialists offer dedicated services that offer healthcare providers much higher accuracy and consequently help them save a lot more money.
When patients receive medical assistance from a hospital or a clinic they have to provide some very detailed information about themselves and data security becomes a serious concern. This includes all kinds of information including their banking information, insurance information, citizen ID, medical history information, and many other things. While the hospital may not have bad intentions, it is very easy for people in the process to leak this information.
There is a lot of demand for this high-quality accurate information and people are willing to pay a lot of money to get their hands on it so ensuring that it stays confidential is critical. Charge entry specialists will use dedicated communication lines secured with VPN or SFTP to ensure that everything has maximum security.
Claim denials are a very expensive cost to bear for healthcare providers. Considering that they have hundreds and even thousands of cases being processed on a daily basis, even a low percentage of 2% or 3% can mean a lot of money lost due to inaccurate reporting and consequently not getting paid for services they have rendered. Working with a charge entry specialist gives healthcare providers the resources and the knowledge they need to deal with claim denials when they occur. There is no way to completely eliminate the possibility of claim denials coming up but it certainly helps to know what to do when the situation arises and to have a team that has already done it many times before. A proficient charge entry specialist will not only reduce the time it takes to handle these cases but will also highlight flaws in the system that have led to this problem and offer solutions so that this situation doesn’t arise again in the future.
Charge entry efficiency plays a big role in how well the company is able to manage its cash flow and how smooth the entire process is for the patient and the healthcare provider. Getting reimbursed for services that have been provided depends a lot on how efficiently the charge entry specialist assigns codes to the different services that the patient has used. Hospitals and clinics have a lot of expenses happening on a daily basis and without proper coding and charge entry processes it can become a bottleneck in the system and limit the functions of the business.
Billing clients is a lengthy process and there are many things in this process that are repetitious This increases the chances of error and also adds to the list of things that need to be done in the organization. With a proper charge entry system and a proficient team of professionals for these tasks, the healthcare provider can focus on their own operations and increase efficiency throughout the organization.