The Purposes of OR Charge Optimization

In today’s economic environment, patients are more aware of healthcare costs and the entities that determine pricing. As such, there is a higher demand for accountability and assurances that consumers are paying for the care they need. Given the circumstances, hospitals must incorporate OR charge optimization.

OR charge optimization is a practice that hospital charge masters might use as part of their accounting, coding, and reporting efforts. If a hospital doesn’t find ways to optimize, they run the risk of losing money and their patients’ trust. Below is a brief explanation of OR charge optimization.

It’s About Accountability

Operating room charges are part of a hospital’s charge master, which is a list of prices for all of the healthcare services a hospital might offer. This listing is also presented to insurance companies to negotiate prices on behalf of the patient.

Charge optimization is a way for hospitals to remain accountable. It shows that the organization is making reasonable efforts to maintain an accurate and compliant charge master. A hospital that does not do this periodically is subject to higher scrutiny, and might even run afoul of state or federal regulatory bodies. Another function of OR charge optimization is to normalize the operating costs of a hospital. As with any service, health care is subject to market forces. Many factors can influence the price of medical services, supplies, equipment, and overhead costs. By establishing internal processes to oversee these changes, it’s possible for a hospital to save money, reduce redundancy, and increase revenue.