BILLING & COMPLIANCE: Spring Clean Your Chargemaster With These Field-Tested Strategies

Eight Staffers You Need for Spotless Claims
Keeping your charge description master (CDM) up-to-date can feel like an overwhelming task, but dividing responsibility and chopping the workload into small, manageable steps will save you endless compliance headaches, wasted time, and lost revenue.
Since the chargemaster is so vital to your hospital's financial state, it may seem to have a powerful personality of its own but ultimately, you're in control. In the hands of knowledgeable staff members who work efficiently together, it performs like a champ, but if your coders and billers don't put their heads together or your management doesn't keep tabs on what's new, even the most high-tech CDM won't straighten out your claims.
Choose Your Teammates Wisely
Effective and efficient CDM reviews require the collaborative effort of various staff members, says Maureen Drach, RN, BSN, MBA, senior manager of the Integrated Health Group at Deloitte & Touche in Chicago, because multiple fields of expertise are needed to evaluate charges properly and make necessary changes. "No one person or department has all the requisite information to always make the right decisions or to consider all the individual regulatory and data elements of the charge," Drach says. So while the makeup of your team will vary according to your hospital's size and the goals of your review, experts recommend including the following staff members:

Member of the finance department

Member of the billing department

Member of the information systems department

Why? These folks know the complexity of the systems involved in the claims process, so they'll have the nitty-gritty on the operational changes required to put the proposed revisions into effect and they can advise from a practical perspective about what will work and what won't.


Lawyer

Chief compliance officer

HIM coders

Why? Coders have the expertise to tell the group which HCPCS codes fit the services in question, and, along with the CCO and attorney, can ensure that CDM changes follow appropriate guidelines and healthcare regulations.

Chief financial officer

Why? As an administrative honcho, the CFO not only can lead the team and govern the project's direction but also can spread the word to the rest of the facility to gain their support.


Department managers

Why? The hands-on experience of these personnel equips them to offer focused insights about department-specific problems such as whether a procedure should be hard-coded or soft-coded and provides the crucial link between the whole and its parts.

Assign the bulk of responsibility for regular CDM maintenance to the department heads, [...]

- Published on 2003-05-01