Charge Capture Improvements Increase Revenue by $552K

EFFECTIVE CHARGE CAPTURE PROCESSES CRITICAL TO SUCCESS

In the post–COVID-19 era, being paid appropriately for services is vital. A health system’s financial well-being is dependent upon effective charge capture processes. Without it, an organization is unable to generate revenue for the services rendered.

LACKING INTEGRATED REVENUE CYCLE DATA HINDERS IMPROVEMENT EFFORTS

Blessing recognized the process it used for charge capture wasn’t keeping pace with the changing reimbursement environment and lacked the flexibility to adapt quickly. A lack of integrated revenue cycle data hampered insight into charge capture and compliance processes, which made efforts to improve difficult. As a result, submitted claims were not always complete or “clean” (free of errors and omissions and able to be processed without additional information or verification), and valuable revenue was lost. The organization needed a way to not only integrate, centralize, and visualize charge capture issues, but also to identify root causes and quickly address them.

IMPROVING FINANCIAL PERFORMANCE

To minimize revenue leakage and improve financial performance, Blessing elected to implement VitalIntegrity™. This web-based application provides quick, fully customizable rules management, advanced reporting and analytics, and auditing and reconciliation of hospital, professional, and remittance billing information. Blessing uses VitalIntegrity to automate work queues for its analysts. High-value data and analytics presented to the analysts in the application supports them in addressing all charge capture issues at one time. Now, Blessing can review and understand daily charge capture performance and can also audit each step of the charge capture process to identify problem areas and root causes. The organization analyzes its charge capture and compliance opportunities, including missed charges and overcharges. With new insights, the organization identified several improvement opportunities, including:

• Electrophysiology charges for procedures performed in the catheterization lab and angioplasty.
• Infusion and injection charges for bedside procedures.
• Labor and delivery charges.
• Medication charges and units of service for a new, high-cost medication.
• Speech and language charges.

Additionally, automated reports support leaders in monitoring performance, including individual analyst and team productivity.

“VitalIntegrity has enabled us to continually identify charge capture issues, improve our processes, and increase productivity, increasing revenue by more than $550K.”

Diana Kessler, Manager Charge Capture, Blessing Health System

RESULTS

By leveraging VitalIntegrity, Blessing has improved revenue integrity and clinical documentation, enabling it to submit complete, clean claims and collect for the services provided. Results include:

• $552K increase in revenue in one year, the result of improved charge capture accuracy.
• >25 percent increase in charge capture team member productivity, creating capacity for increased performance audits, issue identification, and issue resolution.
• Successful auditing of 100 percent of all charges, ensuring ongoing regulatory compliance.

WHAT’S NEXT

Blessing will continue to use VitalIntegrity for ongoing root cause remediation and continuous improvement.

ADDITIONAL READING

• Charge Capture Analytics Enables $7.8M Revenue Increase
• Charge Integrity Analytics Improves Revenue Recognition, Retaining More Than $6M
• Analytics Driven Improvement Efforts Reduces Surgical Supply Costs by $3.2M
• A Vitalware Case Study: Hendrick Medical Center
• Accelerate Charge Capture Improvement with Health Catalyst VitalIntegrity™