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Related Experiment Videos

Designing and maintaining an effective chargemaster.

D C Abbey1

  • 1Abbey & Abbey, Consultants, Inc., Ames, Iowa, USA. aaclidca@netins.net

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|March 22, 2001
PubMed
Summary
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The chargemaster, a hospital

Area of Science:

  • Healthcare Administration
  • Medical Billing and Coding

Background:

  • The chargemaster is a critical component of healthcare billing, containing charges and coding information for claims.
  • Its complexity extends beyond a simple list, with varying departmental roles and the need for custom code development for complex services.
  • The rise of managed care has expanded its function to include tracking supply and service utilization.

Purpose of the Study:

  • To highlight the complexity and multifaceted role of the chargemaster in hospital operations.
  • To emphasize the necessity of effective chargemaster design and maintenance for accurate claims and utilization tracking.
  • To outline key considerations for optimizing chargemaster functionality.

Main Methods:

  • Discussion of the chargemaster's role in claims development and coding processes.

Related Experiment Videos

  • Analysis of the chargemaster's evolving function in managed care for utilization tracking.
  • Recommendation for establishing a chargemaster coordinator and review team.
  • Identification of critical design issues for chargemaster implementation and maintenance.

    • Main Results:

    • The chargemaster's function is complex and varies across hospital departments.
    • Effective chargemaster management requires dedicated oversight and a systematic approach to design and maintenance.
    • Key design principles include 'form follows function,' coding strategies, modifier treatment, charge development, and integration with other financial systems.

    Conclusions:

    • Hospitals must appoint a chargemaster coordinator and review team for effective oversight.
    • Strategic design considerations are crucial for maximizing the chargemaster's utility in claims processing and utilization tracking.
    • Addressing issues like static vs. dynamic coding, modifier handling, and physician fee schedule integration is vital for optimal performance.