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Q&A: Conducting Chargemaster Audits

Analysis  |  By Revenue Cycle Advisor  
   March 01, 2021

Revenue integrity staff will typically collaborate with the compliance department on audit activities.

A version of this article was first published March 1, 2021, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

Q: What are the recommended primary focus areas when auditing the chargemaster and charges?

A: Revenue integrity staff monitor and audit all charges generated through the chargemaster. Revenue integrity will typically collaborate with the compliance department on these activities to ensure that both departments are kept abreast of the most current government and commercial payer regulations and their interpretation and application.

If errors or other issues are reported, a corrective action plan should be developed. The specific process or processes affected should be audited to ensure resolution and optimize charge entry, billing, reimbursement, and data collection. These audits should determine whether individuals are properly carrying out their responsibilities and make recommendations for education or process improvement if necessary.

For more information, see "Compliance checkup: Monitoring and internal auditing" in the February issue of HIM Briefings.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.

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