Errors in charging can occur if the Chargemaster is not kept in synchronization with the order entry / charge capture systems.
One of the most overlooked areas in the process of conducting a Chargemaster Review is determining if the order entry or charge capture system is correctly aligned or "mapped" to the CDM. It is critical that the order entry system has clearly defined descriptors so that the staff responsible for charging and ordering is selecting the appropriate service or supply. If the order entry and Chargemaster systems are not in alignment, then errors in charging will occur and revenues will decline.
In addition to a comprehensive Chargemaster Review, MedCom recommends that all order entry systems be aligned or "mapped" to the CDM so that existing ordering mechanisms can be evaluated.
We have developed a state-of-the-art software product, customizable by the client that provides a detailed view of the mapping of the order entry items to CDM items. MedCom consultants will review each of the order entry lines and their associated CDM mapping, and issue a report with recommendations for changes. Once approved, MedCom will create an implementation file for each order entry system. This will ensure that the front end is correctly mapped to each of the CDM line items, ensuring full reimbursement for services provided.
"Mapping" Process
- Electronically import all order entry systems and the CDM into MedCom's proprietary CDM Review software, which will show "mapping" errors
- Review all electronic charge capture systems, including hospital-wide order entry systems and specific Radiology, Laboratory, Pharmacy, and Operating Room systems
- Evaluate the appropriateness of the mapped order entry line item to the CDM
- Evaluate all up front manual charge tickets, which often go unchanged for years
- Create and customize implementation files including additions, deletions, and re-mapping recommendations for each order entry system
- Perform a post-implementation audit of changes to ensure the accuracy of the implementation
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