The hospital chargemaster is the heart of the revenue cycle, capturing the costs of every billable service or item delivered at the organization. To keep the heart pumping, providers are turning to hospital chargemaster management vendors to ensure their chargemasters are compliant, accurate, and automated.
Hospital chargemasters must contain a complete list of all the prices for every procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with the services, such as equipment fees and room charges.
The list must also align with the most up-to-date medical billing and coding lists. Not only do hospitals start to deliver new services that must be charged, but the American Medical Association (AMA) and other authors of widely-adopted coding lists also update, add, and remove codes regularly to accurately capture how providers are practicing medicine.
Failing to maintain an accurate list of codes and prices for services rendered means providers are leaving money on the exam table.
But managing the comprehensive list of prices and fees is complex. Many hands contribute to hospital chargemaster management, including staff from the CFO’s office, health information management and coding, auditing, contracting, patient financial services, and clinical care. These chargemaster management contributors also rely on external resources, such as CMS manuals, vendors, suppliers, professional organizations, and payer guidance.
Manual processes exacerbate the already complex task of managing the hospital chargemaster, creating significant revenue capture and compliance risks.
Despite challenges with hospital chargemaster management, new state and federal healthcare price transparency laws are making hospital chargemasters available to the public for the first time.
Automating and optimizing hospital chargemaster management is more important than ever. And hospitals are seeking the help and expertise from vendors to create accurate charge lists, identify areas of revenue risk, uncover opportunities to increase revenue, ensure compliance, and verify that their prices are in line with competitors.
The following alphabetized list details the top hospital chargemaster management vendors by hospital implementation based on data from Definitive Healthcare.
Cerner Corporation
While best known for its EHR system, Cerner Corporation also tops the list of hospital chargemaster management systems by hospital implementation.
Headquartered in Missouri, the publicly traded enterprise health IT company has been developing and installing information technology solutions for about four decades. The vendor has notably become one of the two largest EHR vendors in the US, and currently contracts with more than 27,500 facilities.
As part of its EHR system, the vendor offers hospital chargemaster management tools to help providers bridge the clinical and financial aspects of care. Hospital chargemasters reside in the EHR system and providers are able to load their line items and prices into the clinical system to better understand total cost of care and prevent missed revenue.
While the emphasis has been on EHR and clinical systems, Cerner and other major EHR vendors are venturing into the financial and revenue cycle management space to deliver integrated solutions to their provider partners. The solutions oftentimes include charge capture, a process that uses chargemaster data to create bills for healthcare services.
Change Healthcare
Based in Tennessee, Change Healthcare offers a range of health IT technologies and services to help providers and payers manage the factors making healthcare more complex, including value-based care, increasing financial pressures, and consumerism.
Hospital chargemaster management and charge capture services are part of Change Healthcare’s technology offerings. The vendor’s Coding and Compliance Advocate and Charge Capture Insight help providers identify missing charges, reduce denials, and boost medical billing compliance.
The vendor currently works with 5,500 hospitals and over 900,000 physicians, handling one in three patient records. The vendor is the product of McKesson Corporation and Change Healthcare Holdings Inc. (CHC), which partnered in 2017 to create Change Healthcare.
Epic Systems Corporation
Like Cerner, Epic Systems Corporation is one of the biggest names in the EHR space. Together, the companies claimed 54 percent of all acute care hospitals in 2018, with Epic alone holding 58 percent of the large hospital market, KLAS recently reported.
But Epic is more than just its EHR system. The vendor from Wisconsin also offers a suite of software and services to support providers as they manage the clinical and financial components of healthcare.
Providers using an Epic EHR system have access to hospital chargemaster software to create a single dynamic fee schedule. They can also implement Epic’s Charge Router application to communicate charges from clinical to billing systems.
Evident, a CPSI Company
Rural and community hospitals are turning to Evident, a company part of the CPSI family, to manage their chargemasters.
The company is dedicated to providing EHRs and other technologies to rural and community hospitals and providers. Through their EHR systems, providers can access a hospital chargemaster tool that allows them to populate line items and prices, enabling streamlined charge capture and billing.
Evident also offers a host of other technologies to bolster financial and revenue cycle management. The solutions allow for more end-to-end billing and patient accounting management.
MEDHOST
Used by over 1,000 healthcare facilities, MEDHOST is another top choice for hospital chargemaster management. The company out of Tennessee has carved out space in its EHR system for providers to create and use their chargemasters for more accurate charge capture and billing.
MEDHOST’s primary focus has been on its EHR system, but the company is venturing more into the revenue cycle management space as of late.
MEDHOST recently reported that they launched a new division dedicated to revenue cycle management outsourcing. The MEDHOST Business Office Outsourcing division provides billing services, account follow-up, contract management, denial management, and other revenue cycle management services that fully integrate with the EHR system.
MEDITECH
Rounding out the top hospital chargemaster management vendors according to Definitive Healthcare data is MEDITECH.
Hospitals are increasingly turning to the Massachusetts-based health IT company for EHR and other information technology systems. Notably, 65 hospitals went live with MEDITECH’s Expanse EHR system in 2018, representing a 15 percent boost in new Expanse customers, the vendor reported.
Like many other vendors on this list, MEDITECH offers hospital chargemaster management services within its EHR system. But the vendor is also branching into financial and revenue cycle management solutions to support clinical and financial integration of care.
MEDITECH recently formed a new division dedicated to professional services. Through the new division, the vendor will assist hospitals throughout a MEDITECH EHR implementation by providing on-site project management, clinical and financial leads, and a suite of subject matter experts who can guide, oversee, and train staff during the implementation process.
Automating and streamlining hospital chargemaster management is becoming a new requirement in healthcare. Price transparency laws and financial pressures are requiring hospitals to ensure their chargemasters are not only up-to-date but easily accessible to all departments and patients.
Hospitals are primarily handling their chargemaster responsibilities in the EHR system. Chargemasters are bridges between clinical and financial care, so developing and optimizing the list of services and prices within the EHR can be beneficial for providers.
However, the growing need to optimize hospital chargemaster management is opening the market for other solutions and vendors.
Companies like Change Healthcare, nThrive, and VitalWare are now offering chargemaster management solutions independent of, but still integrating with, an EHR system. KLAS even named VitalWare’s VitalCDM, Craneware’s Chargemaster Toolkit, and nThrive’s CDM Master as the top hospital chargemaster management solutions in 2019.
The market for hospital chargemaster management solutions is likely to grow as the industry dives deeper into price transparency and hospitals explore new strategies for capturing revenue.
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Photo courtesy of: RevCycle Intelligence
Originally Published On: RevCycle Intelligence
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