Are You Recognizing All Room and Bed Charges Accurately?
By: Videl Nelson, Revenue Integrity Consultant
Are you recognizing all Room and Bed charges at your organization? This may be a difficult question to answer if you do not have a mechanism or report to manage and track this type of data within Cerner Millennium.
One of the most important charges to make sure is recognized on the inpatient side of the house is the Room Care charge, also referred to as the Room and Bed charge. This charge encompasses the utilization of the room and supplies and in some cases, the Room and Bed charge may be the only chargeable item on a given encounter.
In addition to capturing the Room and Bed charges for credit of the service provided, its equally as important to ensure that you are not overcharging for Room and Bed as this leads to downstream fines and penalties. In May of 2014, the Office of the Inspector General audited the state of New York resulting in the state owing the Federal Government $60.8 billion due to claiming unallowable Room and Board charges over a three-year-period.
Many factors can cause an organization to miss capturing a Room and Bed Charge, such as the Patient Status Order (PSO) being added to PowerChart™. The PSO orderable allows physicians to make immediate changes to a patient’s encounter via signing an order in PowerChart™. These encounter changes include tasks from starting or ending observation on a patient’s encounter to admitting a patient from observation simply by completing a PSO to change a patient’s encounter type. A patient’s encounter type, accommodation, time of admission and time of discharge are the important factors when determining the appropriate Room and Bed charge for a given encounter. The involvement of the PSO workflow, which can alter all the mentioned factors, can sometimes cause over or undercharging of the encounter’s Room and Bed charge.
To avoid missed or incorrect Room and Bed charges, one person from each department should reconcile the census report with a charge report. This means that person should log in to each patient and check for these room and bed charges, which could take from one to two hours per day per department. Then organizations have to set up automated patient accounting rules to have the system calculate if there are enough "Person Management" (Room and Bed Charges) for the encounter. Even with these processes in place, charges still get missed.
If you are not confident that your organization is capturing 100 percent of your expected Room and Bed charges or the appropriate observation hours, let’s chat. Softek created a Potential Missing Room and Bed Charges Report within our Charge Capture suite that gives Cerner clients the ability to identify potential missing room/bed charges, incorrect observation charges and accounts with potential charges that require review. This report allows the client to capture and correct charges before the claims are processed to avoid any late charges.
Softek’s Potential Missing Room and Bed Charges Report shows encounter transitions, encounter dates, expected charges, exclusion hours, actual charged amounts and missed charges for a given encounter. With this visibility, you can capture and correct charges prior to claims being processed, avoiding charge capture issues down the road.
What does Softek® do?
Softek’s mission is to help hospital systems get the most out of their investment in Cerner® Millennium™. We do this by providing innovative software solutions and consulting services that can achieve more together than either can alone.
At Softek, our team of innovators and software developers brings expertise beyond the ordinary to every client. Our experts are involved with Cerner® Millennium™ hospitals throughout the country, consulting clients so they can optimize system performance and revenue integrity.
Softek delivers a full suite of consulting services and software solutions to assess and optimize EMR system performance, including revenue cycle integrity and patient accounting.
Softek was awarded 2021 Best in KLAS for Revenue Cycle Optimization.
Let’s talk to see how you can get the most out of your Cerner® Millennium™ system.
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