Comprehensive Chargemaster Review

Comprehensive Chargemaster Review

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Advantage

MedCom has provided hundreds of Chargemaster reviews throughout the country over the past 35+ years for organizations such as Cleveland Clinic, Tenet Healthcare, as well as many community medical centers and critical access hospitals.

Our smallest ROI is 300%. In the Comprehensive Chargemaster Review, MedCom combines its proprietary software technology and extensive clinical expertise to provide a complete, efficient solution to address revenue leakage issues and potential compliance problems.

Increase Charge Accuracy

With extensive knowledge, expertise, and advanced technology, we can help you meet the challenges you face today and prepare you for the future by examining the ChargeMaster data, system connectivity, and charge capture process. We also monitor payments to provide insight into opportunities for improvements.

  • Chargemaster Examination

    • Invalid CPT/HCPCS Codes
    • Invalid CPT to Modifier Relationships
    • Inconsistent CPT/HCPCS Code Use
    • Invalid or inappropriate Revenue Codes
    • Inconsistent descriptions

  • Pricing Analysis

    • Inconsistent prices across departments
    • Identify current prices below fee schedules
    • Index current charge against Medicare reimbursement rates
    • Market Price comparison for price transparency and defensibility
    • Assessment for payor contract negotiation indicators

  • Charge Capture Assessment

    identify missing charges based on multidimensional volume comparison.

    • Code Pairs Volume Comparison
    • Market Volume Comparison
    • ChargeMaster Volume versus 835 Volume Comparison

  • 835 Analytics

    • Payment trends over time and by payor to identify large variables across multiple periods
    • Claim level charge analysis, payments, zero payments, shows claim payment by period and payor
    • Denial activity analysis provides insight as to why claims are not receiving full reimbursed
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