Question

Scenario: The chargemaster at your facility has had only limited updates over the past 3 years. The updates are only made when someone has a few minutes to work on it, as no one has the responsibility to keep it current. As you would expect, the facility is receiving many denials due to invalid codes and other errors in the system.

Since you have been hired as the chargemaster coordinator you have been charged with cleaning up the chargemaster as well as creating a process that will keep the chargemaster current on an ongoing basis. But first you need to identify the problems that have caused the chargemaster to be out of date.

Create a fish bone diagram (aka root cause analysis) of the problem.

Create a written process for ongoing maintenance for the chargemaster.

Answer 1

CHARGEMASTER: is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital.

First of all avoidance is the main reason for lack of skills in developing a valid charge description in an organization. Moreover, codes are primarily used in outpatient procedure which means the chargemaster should be aware of new codes being used in hospital charges. This includes accurate and clear recordings to preventive measures. Then, the chargemaster role is to save others time and money in the long run. If these roles are done accurately by a chargemaster, then the person will be aware of their roles in an institution.  

To work as an effective chargemaster, he should be update with the recent changes happened in the standardized process. It should be periodically reviewed systematically and verified but the codes should be completely and accurately mentioned while using in an outpatient procedures. Focussing on correct, complete and compliant coding in reviewing department chargemasters streamlines the ongoing chargemaster maintenance. Ultimately, maintenance results in all chargemaster issues being addressed and requiring less effort.