The Chargemaster’s Role in Building Trust and Improving Operations

By Kerry Martin, CEO, Vitalware
Twitter: @Vitalware

A successful hospital requires that a patient has absolute faith in their ability to make the best medical decisions on their behalf, which includes medical expenses. This means that a hospital needs to be set up to provide informed, accurate descriptions of pricing for procedures, supplies, and medication. Thankfully, there are new charge description master (CDM) management solutions that help hospitals keep track of expenses and pricing data.

But, CDM maintenance solutions aren’t all made the same. So, how can you be sure that the solution you’re choosing to manage your CDM will improve your work environment and revenue efficiency—and not leave you playing catch-up every day? You can make sure it has these seven capabilities:

  • Incorporate ALL of your data in a comprehensive view
    Having to look across multiple systems to retrieve all the data needed to maintain a chargemaster is time consuming and painfully inefficient. The same can be said for solutions that require complicated data specs for integration into their solution. Many tools aren’t able to consume a full data set or make it easily viewable, the onus then falls on manual efforts to consume, consolidate, and interpret data – leaving plenty of room for error. To avoid disparaging your credibility and compliance record, make sure you’re choosing a solution designed to incorporate your complete CDM file in an easily exportable format.
  • Manage all fee schedules
    Fee schedules are complex and many CDM maintenance solutions lack the capability to load as many fee schedules as needed, making pricing analysis within a single solution impossible. While there are some workarounds, they are often a tedious and time-consuming experience. The result? Many pricing teams skip an annual review for an every other, or even every third-year review.When investing in a CDM management solution, you should choose one that is going to be the most efficient overall, especially when it comes to fee schedules, which is needed for both charges and reimbursements.
  • Comprehensive view of important components
    Pharmacy, supplies, professional chargemaster, preference list management, order entry, soft coded items, radiology and lab are all vital in a hospital, so you’ll want a solution that manages all of this information without having to look at extra modules or add-on products. Having your professional chargemaster and hospital chargemaster in one platform makes creating a comprehensive data analysis that much easier – not to mention, much more accurate.
  • Flexible Workflow
    Workflow flexibility is a key component for keeping your CDM up-to-date, and handling changes accurately and efficiently. Yet, some workflow solutions are completely separate from CDM tools, which means you have to leave your CDM management environment. Others impose restrictions on workflow which makes working with them feel less intuitive and logical, slowing throughput, adding cost, and leading to errors. Look for a solution that allows you to customize workflows to match your data and tasks as well as anticipate the range of potential outcomes for any given request.
  • Real-time access to regulatory content and compliance standards
    Rules and regulations in the healthcare industry are constantly evolving. Your CDM management solution should be able to update with these changes in real-time to help you stay ahead of new rules and regulations. In addition, behind your CDM management solution should be a content team available to you if you have questions regarding compliance. Many mistakes or compliance issues could be avoided by having access to informational resources that are comprehensive, integrated into your system, digestible by your team, and most importantly, up to date.
  • Integrate relevant data, reporting, and analytics
    Make sure your CDM maintenance solution integrates all relevant data and pertinent reporting, to provide your team with both the global view and detailed insight they need. This will enable you to improve margins by decreasing denials, while capturing more accurate revenues and enhancing the overall patient experience. Complete visibility and analysis into your data not only allows you to run your CDM more cohesively, it positions your CDM to help you assess, plan, and strategize to manage your business for the future.
  • Web-based solution, with automated updates
    If your CDM isn’t web-based then it is far behind the curve. As one of the most important solutions in the daily business operation of a hospital, an out-of-date chargemaster solution is unacceptable. Look for a solution with a current architecture, allowing for complete and flexible data consumption as it will offer:

    • Complete data usage
    • No IT reliance…or presence
    • Centralized operations
    • Automated, seamless, interruption-free updates
    • No manual downloads

Don’t let your CDM be a technical laggard. It’s just too important to your daily operation and the overall health of your business.

Final thoughts
Your hospital’s CDM plays a major role in building trust within a hospital—for patients and staff alike. At the end of the day, you should focus on finding a CDM management solution that improves efficiency and reduces compliance risks. Find what works best for your hospital and ensure that it strengthens day-to-day operations.