Charge Master Review

A – Assess

A charge master assessment is one of the most critical elements of APC preparation, beginning with questions such as:

• How many charge masters does our organization have? (Important for integrated systems with multiple hospitals and/or provider-based entities)
• What recent work has been done on the charge master(s)?
• Have "feeder" systems to the charge master(s) been evaluated?
• Have front-end systems and tools been fully evaluated?
• Have APC-affected department managers been identified and included in the charge master review process?
• Are identified revisions/updates complete?
• Is there an on-going process in place to assure the timely and accurate update of the charge master(s)?

P – Prepare

• Review the charge master(s) for APC accuracy and compare charge description text to the assigned CPT code.
• Analyze the charge master to identify duplicate line items and to assure one CPT code per procedure.
• Submit CPT code description information to the clinical and manager staff for consideration in adding, deleting or clarifying CPT and/or HCPCS codes.
• Interview managers to engage and educate them to their critical role in the charge master update process, and to validate the accurate reflection of services currently rendered in their department.
• Prepare final corrections to the charge master(s) and perform quality check procedures.
• Create an accurate and timely process for the update and revision of the charge master and all related charge documents.

C – Communicate

Education and training on the charge master update process, including departmental responsibility and accountability, is critical to the success of on-going update efforts. Communication programs should be designed to:

• Involve Ambulatory Department Managers and key staff in the policy preparation process.
• Deliver facility-wide education on the critical importance of charge master updates.

HSMN fulfills a variety of roles for clients in need of charge master review services. Our professional staff has conducted comprehensive charge master reviews for many organizations that do not possess the staff or resources to conduct an internal review. HSMN has also been successful in facilitating and leading this process for Hospital or System-wide APC and Charge Master Review Task Forces.