Optimizing Healthcare Payments Through Accurate Charging

In hospital finance, small errors can cost millions. A single misaligned charge description, an outdated code, or a gap between the clinical order and the chargemaster can silently drain revenue month after month. The challenge? Keeping people, processes, and systems perfectly in sync while regulations and payer rules change constantly.

At MedCom Solutions, we know that the key to protecting your bottom line is accurate, fully aligned charging—and we’ve built a solution that makes it possible without adding administrative burden.

The Three Pillars of Accurate Charging

Hospital reimbursement depends on three essential components working in harmony:

1. People – staff who understand and apply regulatory and clinical charging requirements.
2. Clinical Order Systems – reflecting the actual care delivered to the patient.
3. The Chargemaster – the structured foundation of all hospital billing.

A well-maintained chargemaster ensures every patient claim is compliant and fully loaded. But when the charge item description, clinical order entry item, and CPT/HCPCS codes are out of alignment, the result can be lost revenue, compliance risk, and operational inefficiency.

Closing the Gaps with CMNavigator-CDM

To tackle this challenge, MedCom Solutions created CMNavigator-CDM—an AI-powered solution that continuously monitors and corrects inaccuracies in charge descriptors.

By ensuring descriptors are precisely matched to both clinical orders and regulatory codes, CMNavigator-CDM helps hospitals minimize reimbursement risk and optimize financial performance.

Key Benefits of CMNavigator-CDM:

1. Improved staff understanding of regulatory charging requirements
2. AI-driven detection and correction of inaccurate charge descriptors
3. Monthly validation to ensure order entry and chargemaster alignment
4. Real-time updates for regulatory and payer coding changes
5. Confidence that charges reflect actual patient services
6. Volume benchmarking against internal and market-based data

Why Order Entry Should Lead Charging

We believe order entry systems should drive the charging process—because they reflect the actual care delivered. When combined with CMNavigator-CDM’s AI intelligence and our expert support team, hospitals can ensure charging practices are accurate, compliant, and optimized for maximum reimbursement.

Accurate charging isn’t just about protecting revenue—it’s about empowering healthcare organizations to focus on what matters most: delivering exceptional patient care.

Ready to revolutionize your chargemaster management? Contact MedCom Solutions today to learn more about how CMNavigator can transform your hospital’s operations.

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.

Learn more about our solutions or visit our homepage and contact us today!