What is Charge Capture in Healthcare?

It seems you’ve made your way to pMD and want to know more about charge capture. This overview is your guide to understanding what charge capture means, why it’s important, what processes physicians use to capture charges, and how you can optimize your practice’s process and maximize reimbursement. Let's begin by answering the question, “What is charge capture?”

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So, What Exactly is Charge Capture?

Charge capture is a process used by doctors and other health care providers to get paid for their services. In its simplest form, charge capture can be defined as the process whereby doctors record information on their services, which is then sent out to different payers and insurance companies for reimbursement. 

For example, let’s say a physician sees a patient in the hospital, and after 30 minutes of care, the physician diagnoses that patient with hypertension. Both the hypertension diagnosis and the 30 minutes of care translate into separate codes which are eventually submitted for reimbursement.

According to research by the Healthcare Financial Management Association (HFMA), medical practices typically suffer an annual loss of over $100,000 due to inefficient charge capture processes. This loss highlights the importance of optimizing charge capture to ensure timely and appropriate payment for services, mitigating the prevalent issue of charge lag—the delay between when a service is provided and when it's billed.

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How Are Charges Captured?

One of the big variables in charge capture among medical practices is the way in which doctors record and transfer this information back to their offices and billing staff.

Pop Quiz: What are doctors using to capture their charges?

A) Smartphones
B) Post-it notes
C) Spreadsheets
D) Cafeteria napkins
E) All of the above

The correct answer? E. There are numerous ways to capture charges for medical billing, and as you may have guessed, some methods are certainly more effective than others.

Although the quiz lists four different ways of capturing charges, all four are one of two types: Paper (B-D) or Mobile (smartphone). Which one do you think is a better, more efficient process?

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Paper Charge Capture

Historically, charge capture was predominantly paper-based, involving the manual recording of services on paper forms, superbills, or charts, which were later processed by the billing department. Despite its simplicity, this method is susceptible to numerous challenges, including the risk of lost or incomplete forms, human errors in transcription, and consequent billing delays that result in charge lag and potential revenue loss.

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Mobile Charge Capture

The creation of the smartphone ushered in the era of mobile charge capture solutions, marking a significant improvement over paper-based methods like index cards, hospital print-outs, or cafeteria napkins. Electronic mobile charge capture ensures faster reporting and greater billing accuracy. When doctors submit charges electronically, it reduces data entry errors along the way and eliminates the need to decipher enigmatic handwriting. And when you’re busy caring for patients, who really has time to memorize thousands of diagnosis and charge codes? Plus, paper can't keep up with ever-changing government regulations such as MIPS, but electronic charge capture can incorporate many solutions right into the software to make things as easy as possible.

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Why Physicians Prefer to Use Mobile Charge Capture: The Advantages

As you can see, the best and most efficient form of charge capture involves using mobile devices such as smartphones or tablets. Doctors can record their charges using a charge capture application on their phones, allowing them to enter charges on the go. With advanced code search functionality, it’s unbelievably fast and easy, giving providers a convenient way to select customized diagnosis codes during the charge capture process. And because they can submit these electronically, doctors no longer need to shuttle paper charges back and forth from the hospital to their office. In essence, it extends the practice to the hospital and the hospital back to the practice, so providers can stay on top of everything in real-time.

Enabling healthcare professionals to input service data directly into mobile devices at the point of care, this digital approach offers:

• Reduced Charge Lag: Immediate data entry facilitates quicker billing, improving the revenue cycle.
• Increased Accuracy: Built-in validations in mobile systems help minimize coding errors.
• Enhanced Efficiency: The automation of data entry streamlines the billing workflow.
• Improved Compliance: Regular updates in mobile solutions ensure adherence to current coding and regulatory standards.

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Potential Increases In Revenue Motivates Many to Make the Transition

The migration toward mobile charge capture is motivated by the healthcare sector's imperative to bolster operational efficiency, curtail billing inaccuracies, and diminish revenue leakage.

Charge capture is a critical process in healthcare finance, bridging the gap between the delivery of medical services and the financial reimbursement for those services. According to research conducted by the Healthcare Financial Management Association (HFMA), medical practices typically suffer an annual loss of more than $100,000 due to inefficient charge capture processes. This stark figure highlights the importance of optimizing charge capture in hospital billing, ensuring that healthcare providers get reimbursed properly for the services rendered to patients.

Mobile charge capture solutions enable healthcare establishments to navigate the billing process more accurately and efficiently, thus fostering a more financially secure and sustainable practice.

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What About Security?

Mobile charge capture is also the most secure method because all the data is encrypted, both on the device and in transit. This way, doctors don’t have to worry about misplacing a paper charge and putting confidential patient information at risk. 

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What Information Do Doctors Need to Capture?

In an effective charge capture process, healthcare providers document several key pieces of information post-service delivery. This includes:

• Specific services rendered, typically denoted using Current Procedural Terminology (CPT) codes.
• Corresponding diagnosis codes that are justified using International Classification of Diseases (ICD) codes, which validate the necessity of the provided services.
• Precise date and location of the service delivery.
• Any supplies or medications utilized during patient care.
• Quality-of-care information commonly known as the Merit-Based Incentive Payment System (MIPS).

This comprehensive and accurate documentation is crucial not only for billing but also for maintaining compliance with healthcare regulations and fostering quality patient care.

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How pMD® Can Help

At pMD^®, we are committed to helping small practices streamline and optimize the patient care episode and the revenue cycle. Whether it's through providing specialist expertise, offering outsourcing solutions, or delivering our integrated services our focus is to enable small practices to concentrate more on patient care and less on billing complexities. We can help your practice consolidate vendors, reduce costs, streamline workflows, improve patient care and satisfaction, and collect maximum reimbursement more quickly.

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pCharge, the Mobile Charge Capture Solution Doctors Love Using

With pCharge, our mobile charge capture solution, you can easily record charges and capture data at the point of care using your phone or tablet. Imagine capturing a charge for a patient in under two seconds with only one tap in our secure app. The Instant Capture feature in pCharge makes it possible!

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Charges Are Submitted, What’s Next?

Capturing charges is one thing, but what comes next? 

The next step is billing and collections, or to put it simply, getting paid. Don’t worry, we’ve got you covered here as well! A big benefit of capturing charges in pMD is the ability to then bill for those charges without needing to use another software vendor and/or service. pMD streamlines the entire practice from point-of-care through reimbursement. With customizable prompts and easy, accurate code selection on the front-end, combined with claim scrubbing, transparency and reporting on the back-end, providers can take care of their patients, while our team of revenue cycle experts will take care of the medical billing and collections. It can be that easy!

Since 1999, pMD has provided intuitive, elegant mobile charge capture software that improves patient care and makes doctors happy. Contact us now to find out more about how pMD can help you or if you're ready, sign up today!

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