In the healthcare industry, efficiently and effectively capturing and processing charges is a critical component of revenue cycle management, and it helps clinicians more accurately capture and bill patients for medical services.

But, with increasing complexities in healthcare delivery processes and larger volumes of patient data, a solution that improves charge capture operations and enhances revenue cycle management is needed.

The solution? Epic Charge Capture.

Read on to learn more about charge capture in Epic and the benefits of the Epic Charge Capture solution, as well as where our team of Epic consultants can fit in your organization.

What is Charge Capture in Epic?

Charge Capture refers to the process of capturing and submitting charges for services provided by healthcare providers to ensure accurate and timely billing for patient care services. The process of capturing charges in Epic involves verifying that documentations accurately reflect the services provided, selecting the appropriate billing codes, and submitting the claim to the insurance company.

What Can Charge Capture Do?

With advanced charge capture functionality in Epic, health systems and facilities can…

  • Document any services performed by physicians or other providers in the patient’s electronic medical record (EMR) in real time
  • Submit claims to the patient’s insurance provider for reimbursement
  • Track and manage revenue cycle processes, including managing claims denials and appeals
  • Minimize issues with missing charges and charge lag across departments
  • Improve time-to-value for charge entry processes and reduce risk for missed charges
  • Ensure patients are billed accurately and efficiently from insurance providers

Key Components of Charge Capture

1) Charge Linking

Orderable/Procedure/Chargeable (OPC) linking, or charge linking, refers to the process of automating charge capture processes by allowing a linked charge to be automatically dropped after a users places and completes an order.

Charge linking is typically used for charges and orders that are always connected to each other for specific procedures. For example, charges for certain medications can be automatically dropped upon administration to make sure patient information is correctly documented over time and medication charges are only dropped after administration.

2) Flowsheet Charges

For clinicians that complete documentation in a flowsheet, a charge can be automatically dropped or recommended in the background or based on the timing of the charge capture process.

With flowsheet-based charge documentation, users can ensure charges are filed in the document at the same time, eliminating the need for additional steps, reducing time needed for reconciliation procedures, and minimizing the risk for missed charges or lost revenue.

3) Procedure-Based Documentation

Proc Doc, or procedure-based documentation charging, is used to drop charges for procedures while clinicians are writing and documenting notes in their SmartForms. This method of charge capture is most often used in Emergency departments and inpatient/outpatient specialities.

Proc Doc helps any hospital or health system leverage procedure note templates to complete charge documentation procedures in a timely manner, keep all documents together in the same system, and improve revenue integrity across the entire organization.

4) Explosion Charges

Explosion charges occur when multiple charges are automatically dropped once an initial charge has been dropped. This makes it easier for providers to reduce reconciliation times and risk for errors by automatically dropping related charges when the charge for the initial procedure has been filed properly in the system.

This charge capture method is most commonly used in outpatient surgery departments to ensure related facility and supply charges are dropped for procedures so patients are charged correctly for their care.

5) Note-Based Charges

Note-based charging procedures offer a better way for providers to keep up with charges and remind them to drop necessary charges for patients. With this method, clinicians can leverage charge capture pop-ups to remind them to drop charges for procedures before patients are billed inaccurately for their care.

Main Charge Capture Methods in Epic

  • Level-of-Service: With automatic coding suggestions and real-time charge capture functionality, Epic users are enabled to leverage automated billing codes and optimized charging procedures to improve coding accuracy and enhance revenue cycle management.
  • Orderable: This method involves charges usually triggered based on completion of tasks or results and integrates with clinical workflows to generate charges for ordered items, streamline billing processes, and configure systems to capture and assign charges properly.
  • Charge Navigator: By quickly identifying missed charges and leveraging integrations with revenue cycle operations, Epic users can use Charge Navigator functions to ensure all charges are captured properly and billing and coding processes are streamlined, improving revenue collection and reducing the risk for lost revenue.
  • Structured Provider Documentation: Structured documentation capabilities, like Flow Sheets and Medication Administration Records, can ensure patient services are documented and coded correctly, improving the quality and continuity of care and reducing the risk for data errors and replication across the Epic landscape.

How Can We Help?

Whether you need help implementing a new Charge Capture application within your Epic landscape, additional support navigating complex integrations between your new and existing Epic applications, or just an extra hand optimizing your day-to-day operations and hospital charge capture processes to improve net revenue, Surety Systems is here to help.

Our team of senior-level Epic consultants has the technical skills and functional expertise needed to lead you to success, regardless of your organizational complexity or nature of your Epic project needs.

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Interested in learning more about our Epic consulting services? Ready to get started on a project with one of our top-tier Epic Charge Capture consultants?

Contact us today for more information!