In today’s healthcare environment, hospitals are under increasing pressure to improve revenue capture, maintain compliance, and keep pricing aligned with market expectations. Nowhere is this more critical than in the surgical department — one of the most complex and revenue-rich areas of a hospital. Surgical procedures often involve dozens of billable components, from operating room (OR) time and anesthesia, to implants, supplies, and other facility and professional fees. Without a streamlined, accurate approach to organizing these charges, hospitals risk revenue leakage, compliance issues, and patient dissatisfaction.
That’s where MedCom Solutions’ CMNavigator-OR: Surgical Theater Charge Acuity System comes in. This advanced tool enables hospitals to review, restructure, and optimize their surgical procedure dictionary and related charges with precision and efficiency, ensuring every billed procedure reflects accurate, compliant, and market-aligned pricing.
Surgical procedures often involve multiple CPT/HCPCS codes, packaged supplies, medical devices and implants, and varying payor requirements. Over time, charge structures can become outdated, inconsistent, or unnecessarily complicated. The CMNavigator-OR simplifies this by analyzing existing procedure dictionaries and creating clear, organized, and compliant charge structures for every procedure.
Benefits:
Billing errors in surgical services can lead to costly audit findings, denied claims, and regulatory penalties. CMNavigator-OR provides a solid foundation to fluidly manage your OR Procedure Dictionary in real-time and on an ongoing basis. The data repository enables fast and systematic export of all surgical procedure names for analytics and overall maintenance. In turn, this facilitates aligned and accurate charge capture across all surgical services enabling hospitals to comply with a multitude of payor guidelines. The CMNavigator-OR ensures charges are fully compliant with Medicare, Medicaid, and commercial payor guidelines by aligning all charges with the most current coding standards and documentation requirements.
Benefits:
Outdated or incomplete charge structures can result in missed revenue opportunities; particularly in high-cost surgical cases. The CMNavigator-OR aligns each OR procedure name with the corresponding acuity and related CPT code references to foster accurate front-end procedure name selection which facilitates appropriate charge acuity selection.
Benefits:
Manually restructuring surgical procedure dictionaries is a time-consuming and error-prone process. CMNavigator-OR automates much of the review, mapping, and restructuring process, significantly reducing administrative burden. This gives clinical OR staff the tools needed for accurate procedure name and charge selection, and revenue cycle and chargemaster teams more time to focus on strategic priorities instead of manual clean-up.
Benefits:
The surgical department is a hospital’s financial powerhouse but without accurate, organized, and compliant charges, significant revenue can slip through the cracks. MedCom Solutions’ CMNavigator-OR: Surgical Theater Charge Acuity System empowers hospitals to streamline their surgical procedure dictionaries and charge structures in an effort to stay compliant and accurately charge for each surgery.
In a healthcare landscape where precision equals profitability, this module gives hospitals the clarity, compliance, and control they need to thrive.
About MedCom Solutions
MedCom Solutions creates patented technology and state-of-the-art software to help medical service providers meet rapidly escalating and changing medical billing demands. For nearly 40 years our Chargemaster, Pricing, and Compliance solutions have yielded hundreds of millions in net revenue for healthcare providers across the country.