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Thread: Charge capture checks and balances

  1. #1
    Join Date
    Apr 2007

    Question Charge capture checks and balances

    AAPC: Back to School
    For those of you that have providers going to other facilities, like admitting and doing rounds at hospitals or doing surgeries in hospitals or ASCs, how do you keep track of the services so you don't miss any billings?

    We are trying to come up with a more solid way to be sure we are capturing all charges. Right now we depend heavily on the doctors "little black books" where they manually write down who they saw and what they did and bring it back to their office staff. This gets entered into the billing system and put on hold until we get the records from the hospital to verify that everything is correct and then it is billed.

    The problem with this system is very obvious, not everything makes it to the black book. So I am looking for ideas or advice on other ways to do this more effectively.

    Right now we are doing a lot of backtracking, I had the dictation staff pull the lists of all my providers dictation for certain time periods and I am comparing that with what we billed. This is very time consuming and it is showing exactly how big the holes in our current system really are.

    Thanks for any input in advance,

    Laura, CPC

  2. #2


    Our facilities provide a complete listing of all cases each week.

    For hospital charges, we just go into the web based system and pull down the census for a given day and start pulling notes, etc...

    If the physician is doing his own coding then we'll just check against the listings to be sure there's a charge entered.

    I have doc's who do it in all different ways ... on index cards, patient stickers, black books, I have one physician who takes a single piece of paper, folds it up as small as possible and carries it around in his back pocket ... when you get the darn thing, it's apart to tear apart! Some others use their PDA's. and well, I actually have another doc that pays someone to follow him around to capture his charges ... ridiculous, I know.
    Last edited by ARCPC9491; 07-24-2009 at 08:27 AM.

  3. #3
    Join Date
    Apr 2007
    Charleston, South Carolina


    A previous doctor I worked with went to the hospital and multiple nursing homes. We came up with an index size template and had thin cards made up with the template that he completed for each patient for hospital care - any type - admits, d/c, daily rounds, ER visits and anything else that happened there. He marked the level of service, diagnosis and some things for him to remember to do, order tests, etc. This worked really well. I then followed up with notes via the online hospital software within a couple of days. For NH visits, the facilities actually provided him with a schedule that he wrote beside each patients name what service was provided. As he was a fantastic documenter, and we did not get NH notes until two weeks later, I went ahead and billed using this form and briefly Q/A his notes when they arrived. I never had to change a level of service. He was great about doing this and once or twice forgot to bring back the form, which he then called the NH and had them fax it to me. I know not every doctor is like this, but it may work for some of you.

    Another thing a doctor I did some billing for did, was he had some kind of software on his blackberry, with a template similar to what I mentioned above and he would not when he admitted someone and mark each day accordingly. I woulnd "hot sync" it daily and again compare notes I got from the hospital system. I have no idea what the program was, sorry.

    Maybe these ideas will help you!
    Machelle Morningstar, CPC, COC, CEMC, COSC
    AHIMA Approved ICD-10-CM/PCS Trainer

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