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re|charge

Charge Capture Review

Lost and Found - Cash 

Other benefits include:

• Increased outpatient reimbursement
• Process improvement to capture all charges
• Reduce auditing costs 
• Increased compliance

The Office of Inspector General of the Department of Health and Human Services has issued a report indicating that it is doubtful that any hospital in the country is billing correctly for APCs, especially in the area of drugs.  The Center for Medicaid and Medicare Services (CMS) has noted a number of services in which hospitals have not billed correctly for services.  CMS has acknowledged their errors in the payment of services and has requested hospitals to resubmit the claims containing these services.

Real Life Results

DCH Health System in Tuscaloosa, Alabama is a three hospital system.  Management realized that with the large number of outpatient procedures it was nearly impossible to insure that all services provided were actually billed.  DCH contracted with re|solution in a re|charge program designed to review two years of Medicare outpatient claims looking for uncaptured revenue.  Over $715,000 was found in additional cash reimbursement at DCH.  In addition, several process improvement initiatives were started that assisted the facility in improving their charge capture processes in its cardiology group.

Methodology

Using proprietary technology and a process which reviews all claims that have potential for additional APC reimbursement, re|charge will identify suspect claims, review the medical record associated with the claim and return a revised claim to the facility.  All of this work is done on contingency with no payment to re|solution unless additional dollars are found.  A no risk program that helps bring your billing back in compliance.