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Are You Neglecting Charge Capture?

Analysis  |  By Alexandra Wilson Pecci  
   January 15, 2019

Despite calling it "essential," many healthcare leadership teams discuss charge capture once a month or less.

Despite its importance, charge capture doesn't get the attention that it deserves, according to a survey of revenue cycle leaders.

Although 78% of respondents characterize charge capture as "essential" to their organization's success, leadership teams at 40% of organizations only talk about it once a month or less, finds the Ingenious Med survey.

One-third (32%) discuss it weekly; 18% discuss it twice a month; 8% discuss it daily; and 2% never discuss it.

"It is surprising to me that on average, organizations are discussing charge capture only once a month or less," Eduardo Medeiros, CFO of SUN Behavioral Health in New Jersey, and one of the survey respondents, said via email. "To me this is a critical piece for organizations to ensure the accuracy of their revenue. Charge capture should be monitored regularly, much more frequently than once a month."

Maximizing efficiency

The survey also asks whether physicians or coders are ultimately most responsible for charge capture.

It shows that 40% of revenue cycle leaders say the doctor and the coder should be equally responsible for accurately capturing charges; 19% believe the responsibility rests more on the coder than the doctor; and 31% say the doctor should be held more responsible than the coder.

Also, more than half (53%) say their coding department spends between 10% and 25% percent of their time tracking down information from physicians.

However, coders at top-performing organizations (as ranked using six revenue cycle measurements, including denial rate and average accounts receivable days) aren't spending most of their time chasing down information from physicians.

In fact, one-third of top-performing organizations say their coding departments spend less than 10% of their time this way.

According to Bryan Goble, director of product management at Ingenious Med, top-performing organizations achieve this kind of efficiency by "providing physicians with additional training and access to performance metrics."

Top-performing organizations also maximize efficiency in other ways. For instance, they operate with fewer coders.

"It's not surprising that top performers reported employing fewer coders than other organizations," he said via email. "They don't need as many because physicians have the tools they need to reduce the dependency on them and still ensure financial performance."

Who's responsible?

Ultimately, charge capture is everyone's responsibility.

"Effectively managing charge capture requires a team-based approach, and should involve multiple stakeholders from the facility including the business office, IT, and clinical team, to make sure charges are captured correctly on a regular basis," Medeiros says. "Organizations should also conduct internal team and external vendor audits regularly to ensure there are no major risks to the organization."

David Kelly, director of revenue cycle and managed care at Mary Rutan Hospital in Ohio, and another survey respondent, agrees, saying via email that "organizations should make charge capture and reconciliation a priority."

"While precise solutions will vary by provider, increased accountability, the establishment of key metrics and thresholds, and (where necessary) implementing or replacing charge capture software solutions should be pursued," he said.

Alexandra Wilson Pecci is an editor for HealthLeaders.


Monitor charge capture regularly to ensure revenue accuracy.

Provide physicians with training and performance metrics to improve coder efficiency.

Prioritize charge capture with a team-based approach and regular audits.

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