Why Getting Credit for your Work is Now More Important than Ever

By: Jesse Hodes, Vice President of Sales

The Covid-19 outbreak has put many businesses across the U.S. at severe financial risk. In the healthcare space alone, hospitals are losing an estimated $50 billion a month, according to the American Hospital Association, with most hospitals reporting seeing between 40 to 70 percent fewer patients from late March to early May. These staggering losses have many healthcare leaders questioning what the future holds and prioritizing where their budgetary needs should go with reduced revenues.

What many hospitals are unaware of though is that they have never been capturing the full amount of revenue they should have been in the first place. After all, to maximize revenues, you must first ensure that you are getting credit for 100 percent of your chargeable work being done on the clinical side. And while CFOs are staring at AR days, DNFB data and Cash Collections, what they do not see are the important metrics revenue integrity departments should value: chargeable work to charge generation.

Here are some common scenarios we see at Cerner organizations we work with that lead to unexpected charge capture issues:

  • A client is completing chargeable orders but is unaware that charge build is not set up for specific locations or encounter types. This leads to the order only posting charges on certain patient scenarios.
  • PowerForms charging for some alpha responses and not others. Why would you be charging for a Venous Blood Draw, but not a Capillary Blood Draw? Well, because each individual DTA or alpha response on a form has its own unique charge build which must be set up to post charges properly.
  • Physician notes being documented and verified but not finishing the workflow of posting a charge. After all, a doctor’s job is to provide care. The doctor’s priority is documenting, not making sure a charge was dropped.
  • Quantity Conversion Factors (QCFs) inaccurately keyed in for reimbursable pharmacy drugs. This causes Medicare to reimburse based on this billing unit, which might be a portion of what you should be receiving per volume of drug.

Do you have checks and balances in all these areas? And if so, how long does it take your department to reconcile charges in these areas? Did you know Softek has several controls to address these issues?

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 2020 KLAS Category Leader for Revenue Cycle Optimization.

Let’s talk to see how you can get the most out of your Cerner® Millennium™ system.