kevbshields
Guest
I wouldn't' use the word "replace." Chargemasters are designed to automate the process of billing for certain, "routine" items. Generally these are the 7s, 8s, and 9s of CPT and HCPCS (if appropriate). Granted, it would require the work of multiple coders to absorb this task in place of the chargemaster; they are really a tool to ensure consistent charges across patient accounts.
The folks who are utilizing the chargemaster may not be coders. Keep in mind, these folks aren't coding per se, so much as they are selecting the service provided to the patient. Most hospitals employ a chargemaster manager who has experience in coding, HIMS or billing. Theoretically, that individual and whatever analysts work with that individual should have technical expertise enough to create chargemaster processes that are in compliance with industry standards. Translation: the professionals responsible for chargemaster set-up and maintenance should be certified coders who know what they're doing. In that way, charges automatically "fall" onto the bill based on providers or staff selecting the service they performed, which pulls the correct codes to describe that service.
However, HIMS/Coding should get chargemaster cases/charts to review when a billing or claim scrubbing edit occurs; this ensures that another set of eyes (with coding experience/expertise) have viewed and corrected any issues on the claim before it is sent forward to the payer.
Each facility may have its own approach to this process or chargemaster establishment, so keep variance in mind as you come to understand the use of these tools.
Hope this helps.
The folks who are utilizing the chargemaster may not be coders. Keep in mind, these folks aren't coding per se, so much as they are selecting the service provided to the patient. Most hospitals employ a chargemaster manager who has experience in coding, HIMS or billing. Theoretically, that individual and whatever analysts work with that individual should have technical expertise enough to create chargemaster processes that are in compliance with industry standards. Translation: the professionals responsible for chargemaster set-up and maintenance should be certified coders who know what they're doing. In that way, charges automatically "fall" onto the bill based on providers or staff selecting the service they performed, which pulls the correct codes to describe that service.
However, HIMS/Coding should get chargemaster cases/charts to review when a billing or claim scrubbing edit occurs; this ensures that another set of eyes (with coding experience/expertise) have viewed and corrected any issues on the claim before it is sent forward to the payer.
Each facility may have its own approach to this process or chargemaster establishment, so keep variance in mind as you come to understand the use of these tools.
Hope this helps.