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Significance of Charge Entry in the world of Medical Billing and Coding

The process of Medical Billing and Coding originated way back in the 17th century in England. It might as well sound astonishing that the ICD-9 codes have been dated back to being used in the 17th century to find out the frequent causes of death. Over the period of years, the process of Medical Billing came into play and now healthcare systems across the world are following their own billing processes.

When it comes to the Revenue cycle management, everyone talks about the importance of medical coding and AR follow up as the important aspects of Medical Billing and coding process. A very essential aspect upon which the entire claims process is the charge entry. Charge entry is the first step in the process of Medical Billing, and it is very significant for us to eliminate errors and maintain high efficiency in the charge entry process for a healthy Rev Cycle.

Charge entry refers to the process of creating the claim and entering charges for the treatment given to patients. Charges or appropriate $ value are entered against the patient accounts depending upon the codes and Fee schedule. Providers’ reimbursements are dependent on accurate charge entry process.

All errors in the charge entry process are reflected immediately, as claims get automatically rejected upon transmission. The industry standard of clean claim rate is at least 96-98%, and this is highly dependent on an error free charge entry process. A study from Change Healthcare shows that the average cost of initial submission of a claim is around $7 and when claims are rejected it costs $25 more to resubmit those rejected claims. Let say a practice sends 50 claims a day and 5% of the claims are rejected, that’s about 2.5 claims a day or $62 spent to resubmit. Doesn’t seem much? Just think about it, for a year, it costs around $17,000 just for resubmission of rejected claims. Shocking now, isn’t it?

To know more about the clean claim rate and how healthcare providers can maintain the practice’s first pass resolution rate under medical billing and coding services, click here

The Fully automated process of charge entry

In today’s scenario, the entire process of charge entry is inbuilt, i.e. the billing system is equipped to automatically create charges. So, does that mean that there are no errors occurring? Absolutely no! Because if that be the case, then there should be no rejections at all, right?

Quintessence has dissected the various aspects of charge entry and have ensured process efficiencies with our tools that has automated the entire process up-till payment of the claim. Our BOT’s carry out the same functions as that of a biller would undertake till successfully sending the claim to the payer. We map the BOT’s on the same lines of the payer/client/and billing requirements that ensures that every charge that is created has already been scrubbed and ready for transmission. The ease of implementing these BOT’s is such that it runs along your existing PMS, but at the same time designed with the ability to function independently as well. The following are the immediate visible results that you get with our BOT’s

  1. Increases transmission time and hereby reducing billing cycle to less than 24 hours
  2. Reducing cost per claim
  3. Clean claim rate of 98%
  4. Minimizing revenue leakages by identifying revenue opportunities through our charge audits

Quintessence does not allow transmission of any claim without due scrubbing process. Edits are set in place that ensures that the claim is submitted to the right payer. Any missing or incorrect info on the claim is captured during our audit process and is transferred back to the charge entry team for manual correction. We understand that the process of charge entry plays a crucial role in the health of a practice, and we at Quintessence have left no stone unturned. Our comprehensive audit process not only eliminates errors, but also paves the way for increasing the efficiency of medical billing and coding services. Our idea of using tech is not just to reduce costs or increase revenue but provide us with opportunities for scalability. Call us to find out on how our intelligent tech and automation infused services can simplify your RCM needs as easy as a retail experience.

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