5 FAQs: Charge Entry in Revenue Cycle Billing

In the charge entry process, the responsible staff assigns the required amount of service charge to the respective patient accounts. It is done by looking at the codes charted in the medical procedure and the physician’s fee schedule. To make the revenue cycle billing a proper and effective one, you must eliminate any errors at this very step before moving further. The specialist also needs to go through a large amount of data to ensure that the information entered in the forms is absolutely accurate. Each and every step of this process affects the reimbursement amount ultimately received by the healthcare provider.

The charge entry requires acute attention from the staff as many intricate details need to be looked at. All leading revenue cycle billing companies follow structured plans to ensure that every detail is up to date with the required modifications. But how is it done? Here are the steps outlined for you:

Patient Inquiry: Patient inquiry is the most important and foremost step of the charge entry process. The following steps depend on the findings of this step. There can be two situations in this case:

Patient Found: If the patient is found in the system, then their account details are verified in the next step.

Patient Not Found: If the patient is not found in the system, then the billing company gets back to the source healthcare organization. The organization is asked to re-check the details of the patient. The process moves further only when the correct account details are found, and scanned copies are sent to the revenue billing company.

Detail Entry: Once the patient account is appropriately assigned, the details of the patient’s medical services are entered into the system. The experienced leading companies in this domain ensure that these details are present in the form:

Dos

POS

Provider

Facility

CPT Code

Modifiers

Units

Diagnosis Codes

Pre-authorization Details

Units

Referring Physician

Information Verification: Each and every detail mentioned above must be re-checked and verified before moving on to the next step. One mistake in this part of the process will hamper the cash flow of the healthcare provider. If any error goes unnoticed during this process, then it becomes difficult to trace it back when analyzing denied claims. Hence the specialists take special note of the details entered.

Revenue Cycle Billing Procedure:

Keeping the codes charted and the fee schedule in the front, the bill is prepared and assigned to the payer. The payers might be the insurance companies or the patients themselves. It is also important to note which services are covered by the insurance panels to ensure payment accuracy. Expert professionals in this domain make it a point to check if the patients are eligible for the specified service under different plans in the same panel—this narrows down the confusion, both for the provider as well as the patients in question.

Charge entry specialists check the patient demographics during the charge entry process. When looking into the patient’s accounts, the following details are verified in general:

Patient Account Number

Amount of reimbursement allowed

The amount corresponding to the healthcare services rendered

Adjusted amount

Amount paid by the insurance or the patient, whichever the case might be

Any denial related information is also checked

The charge entry procedure is very vital for the revenue cycle management of healthcare organizations. These are the areas where it exerts its direct impact:

The medical information related to the patient and services is checked during this process.

Any missed, or incorrect information is identified and rectified.

If the issue is not resolved in this stage, it directly affects the amount reimbursed by the insurance companies or the patients.

Due to any of these unresolved errors, the denial rate of claims might increase. It leads to severe wastage of work power and delayed reimbursement.

In case of any error, the billers might charge an exorbitant amount to the patient’s account. This causes increased confusion and leaves the patients flustered with the incorrect bill. If not appropriately resolved, it will lead to a loss of patient loyalty.

Any upcoding or under coding issues, even if performed unknowingly, can lead to unnecessary legal hassles and compliance problems. All this will harm the company’s revenue as well as the reputation.

Leading revenue cycle management companies can take care of this intricate process with the help of their experienced professionals. Data entry outsourcing is the need of the hour and is on the rise in the USA. With the outsourcing of the charge entry, you can utilize the in-house staff for more complicated tasks and decision-making procedures. Offshore revenue cycle billing companies have domain experts under their wing who remain up to date with the latest modifications in the healthcare guidelines. It can also save the excess investment for staff training. They remain accountable to their clients while performing the tasks with undivided attention.

To know how to choose a good medical billing company, you can read the article here.

Hope this blog helped you cover the majority of concerns with charge entry in revenue cycle billing. If you have any further questions, write them down in the comment section below. We will definitely get back to you. For more updates on healthcare, technology, and management, subscribe to our blog. Do not forget to follow us on Facebook, Instagram, LinkedIn, and Twitter for regular updates.

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