02 — Capability · BC-1840.10
Revenue Integrity
Record a correct charge for every billable service, supply and drug, priced from one maintained chargemaster, and publish standard charges as the rules require. Setting prices for products outside patient care is pricing.
- Charge Capture
- Charge Integrity
- Chargemaster Management
In scope
- Chargemaster lines, codes, revenue codes and prices
- Charge entry, charge reconciliation and late-charge control
- Charge audits and missing-charge detection
- Standard charge and price transparency files
Out of scope
- Pricing strategy for non-patient products and services (see BC-470)
- Patient-specific cost estimates (see BC-1810.50)
- Assigning diagnosis and procedure codes from the record (see BC-1840.20)
Realized by · 2
- Epic · Revenue Cyclecore via BC-1840.10.20
- Oracle Health · Patient Accountingcore via BC-1840.10.20
Used in · 1
Build it · 0
- Nothing in the library points here yet.
Decomposes into · 4
- BC-1840.10.10Chargemaster MaintenanceKeep every chargeable item on the chargemaster with the right description, procedure and revenue codes and price, and apply annual code and price updates on time.
- BC-1840.10.20Charge Entry & ReconciliationPost charges from clinical activity or manual entry, and reconcile each department's charges to its activity every day before claims drop.
- BC-1840.10.30Charge Integrity AuditFind missing, duplicate and incorrect charges by comparing charges with documentation and orders, and fix the cause in the workflow.
- BC-1840.10.40Standard Charge PublicationPublish the organization's standard and negotiated charges and shoppable services in the format and on the schedule regulation sets.