What is Charge Capture, and Can It Be Automated With EHR?
Nextech Systems
Nextech improves the performance of specialty practices with innovative solutions that drive efficiency and fuel growth.
Sustained success in the specialty healthcare industry requires a tireless dedication to improving your clinical and administrative processes. For example, you may have explored new methods for increasing patient volumes and found ways to cut back on costs without impairing your quality of care. In that pursuit of business excellence, don't overlook your billing documentation. Inaccuracies – especially during charge capture – can negatively affect your bottom line. But what is charge capture and how can you improve the charge capture process?
What Is Charge Capture??
Charge capture is a process to confirm that all billable patient services and treatments were accurately billed and submitted for reimbursement.?
For healthcare, the process is more complicated since it involves submitting payments and reimbursement to multiple insurers, as well as billing individual patients who are also paying for services at med spas, elective treatments, or for their copay or a point-of-service collections. It’s similar to how a restaurant owner may check bill amounts with the restaurant’s inventory each week.?
Why Is Charge Capture Important??
Charge capture plays a few important roles for your practice:
For VRI Retina in Louisiana, improving their charge capture process had a significant ripple effect on their practice’s billing and coding. The practice’s office manager, Lauren Duplechin, said, “Our charting is so much better, and our staff’s coding has improved. We’ve seen improvements all around.”?
How Does Charge Capture Work??
Charge capture is a five-step process that involves collecting patient information, tracking treatments administered, and using that information to make medical billing as efficient as possible. The five steps in the charge capture process are:
Steps one, two, and three can be done on an ongoing basis or a set weekly time. Parts of these steps can be automated with the right EHR, though verification and submitting the claim will most likely be completed fully by your staff.?
To better understand these five steps, let’s walk through a hypothetical example for a patient at an ophthalmology practice. The patient is covered by Medicare and had cataract surgery. The practice tracked that procedure in its EHR and practice management software and already had all the patient’s information – including details on their Medicare plan – in their EHR (taking care of steps one and two).?
From there, the practice’s administrative staff completed step three: using that information to complete the billing process for Medicare. One staff member can then double-check all information was correct (step 4) and submit the claim (step 5).?
Your EHR and practice management software play a crucial role in charge capture and the ability to automate much of the process. Dr. Jody Piltz-Seymour, glaucoma specialist and cataract surgeon at Valley Eye Professionals in Pennsylvania, explains how the right technology systems set their practice up for success, “I can quickly scroll through all of their visits and see pertinent information in a very quick, easy way. I get a real sense of time and how they’re doing.”?
Audit & Refining Charge Capture Processes
As with any process, there are some hiccups that can pop up. To identify any obstacles – whether with staff training or technology limitations – audit your charge capture process regularly and note any steps ripe to be automated or streamlined.?
If there are significant problems found in a charge capture audit, it may be a sign to upgrade your EHR and PM software. A dermatology practice that identifies major tech obstacles inhibiting its ability to automate and optimize the charge capture process, for example, might switch to a dermatology-specific EHR in order to realize the improvements it needs.
While the auditing cadence can differ from practice to practice, once a quarter or twice a year works well for many practices.?
The Difference Between Charge Capture and Coding?
Medical coding and charge capture aren’t the same thing, but they are connected. Charge capture relates directly to billing and reimbursement. Coding formally captures what services were done in a standardized manner.
The two overlap, but coding is also useful to a patient’s medical history and helping to determine future treatments, both by your practice and any other providers they see.
What Are Benefits of Effective Charge Capture??
Small improvements to your charge capture process can reduce billing errors and make it easier to receive medical reimbursements. One study by the Journal of Oncology Practice found even 1% fewer errors in the charge capture process leads to more reimbursements.
One of the biggest benefits of improving your process is that efficient charge capture speeds up your revenue cycle. A speedier revenue cycle means payments come in faster and your staff members spend less time on administrative work and billing. With that extra time, your team can spend more time on other priorities and improve the patient experience.?
An optimized charge capture process benefited The Eye Center in Massachusetts. Dr. Pierre Alfred, the practice’s founder, was used to seeing 50 patients a day. When looking for a new EHR, Dr. Alfred knew the practice needed a system that could process a high volume of patients. His new EHR helped efficiently manage that high patient volume, and it even allowed his practice to increase patient volume further.??
“The clinical team is able to get through the patient’s history of present illness and other consultative requirements very quickly,” said Cheri Wheeler, practice manager.
What Are the Challenges with Charge Capture?
As you evaluate the accuracy and efficiency of your charge capture process, you may notice a few common challenges. These include lost charge tickets, uncompensated waste, and mis-keyed quantities, such as entering 10 appointments instead of 100.?
Many of these challenges boil down to one common culprit: human error. Your staff members are the backbone of your practice, but the bulk of charge capture may not belong on their plates. By leveraging technology to create a more automated system that requires less oversight from your staff, you can overcome these common challenges and experience fewer errors.?
It’s important to note that even sporadic errors may occur in even the most efficient charge capture process, and vigilance is imperative. You should have a thorough verification process and expect the unexpected, even if the majority of the process is automated. Just because an ophthalmology practice, for example, experienced no errors last month doesn’t mean this month will be the same.
What Is the Future of Charge Capture?
The future of charge capture is bright, thanks to advancements in administrative technologies like EHRs and practice management software. Three of the most exciting changes to look out for in the near future include:
Frequently Asked Questions
What Is Healthcare Charge Capture?
Healthcare charge capture is a process to verify billable treatments and services. It also checks a patient’s billing method (which can include full coverage by insurance, an out-of-pocket payment, or a combo of the two). When done effectively, charge capture can speed up your practice’s revenue cycle, getting your practice paid faster and reducing the time spent on administrative and billing tasks.?
What Is Another Name for Charge Capture?
Charge capture is the process of verifying billable treatments and a patient’s billing information. It can also be known as charge capture revenue cycle, medical charge capture, healthcare charge capture, or physician charge capture. No matter the name, the end goal is the same: speed up your practice’s revenue cycle and reduce time spent on billing and administrative tasks.?
What Is Automated Charge Capture?
Automated charge capture is when the majority of the charge capture process (verifying billable services and a patient’s billing and insurance information) is done through an EHR system, not manually by your staff. Automated systems save time and reduce the number of errors.
Time to Improve Your Practice’s Charge Capture Process?
A charge capture process is a continual improvement project. To ensure your process best serves your practice’s needs, take the time to evaluate your team’s process and the technology involved in it.
If looking to improve your practice’s charge capture, Nextech can help. Our EHR and practice management software helps small practices improve their charge capture process and increase their bottom line. Schedule a demo to learn more.