What is charge capture?

Charge capture is recording and submitting for reimbursement all medical procedures and services provided to a patient within the provider's care.

Understanding the concept of charge capture 

Charge capture is a process originating from the need to streamline billing and revenue cycles in healthcare. The process allows for every billable service to be included, no matter what department the charge may have been incurred at. Collecting billable hours is easier by correctly applying Current Procedural Terminology (CPT) and International Classification of Disease (ICD) codes. Administrative and billing staff generate claims for insurers and bill patients in a coordinated workflow. 

How it works 

1. Healthcare providers must document every service they provide to a patient including examinations, treatments, and other medical or clinical interactions. 
2. The proper codes are applied by the billing department or staff responsible for handling billing. 
3. The information is added to a billing system in a charge submission. The step is generally integrated with electronic health records (EHRs). 
4. It is followed by a charge review to confirm accuracy and completeness. The review is conducted by financial auditors or compliance officers in larger organizations. 
5. The charge is compiled into a form submitted to insurers or patients. 
6. Once submitted, an insurer may determine liability based on patient coverage, and service eligibility. If there is no insurer, the patient receives their bill. 

Using email to reduce errors in the charge capture process

A study published in the Journal of Oncology Practice states, “Many practices think that their current processes are capturing all errors or missed charges. However, there might still be an opportunity to further refine the process since even an additional 1% of identified missed charges or errors…”

HIPAA compliant email commonly represents the shift from the charge capture to the billing process. Providers use it as a method to share claims and bills. The role beyond the billing process however relates to the internal application of email to handle queries to clinicians and coders before charge review. An internal application also creates an audit trail to track changes in coding and provide a reference for alterations to charge forms. 

It also helps handle insurers' coding-related discrepancies. Through email correspondence, common errors in a provider's coding pattern can be pointed out and rectified to allow for consistent updating and training on the charge capture process which proves invaluable in smaller providers.

FAQs

What is the billing process in healthcare? 

In healthcare, the process is centered around documenting, coding, and submitting claims for services to patients. 

Why do communications using ICD codes need to be HIPAA compliant? 

The ICD codes often contain or are linked to a patient's data. 

Is the information in an ICD code PHI?

Yes.