Here’s a major truth; all of us likes getting things for free, or for almost nothing. As long as it’s palatable, we’ll accept free food, free drinks, free notepads and pens, free software, even free clothes! If it’s not perfect or what we think it should be, we’ll complain about it if it’s not up to our standards; that’s what we do when we gripe about social media sites. It’s kind of funny, but that’s how all of us are.


Gellinger / Pixabay

I’m not much different. I’ll do a lot of research to find something I can use for free rather than pay a lot of money for it. I’ll also spend a lot of time working out problems with some of the free things I can get my hand on instead of paying someone else to do it. I’ll almost always find the time to do this sort of thing. I do have limits though, which is why I have an accountant, someone to cut my grass and someone to plow my driveway in winter.

If I view things with a different perspective, it’s no wonder some hospitals I send proposals to, with the hopes of doing the work on their charge masters or some of the other services I provide, sometimes balk at the rate I’m charging them. From where I sit it’s not all that high and the return is usually way higher than what I’m asking for. I know what others charge, and I’m well within those rates, but I also acknowledge that it’s a nice chunk of change.

I also know the worth of the work, as well as how long it takes me to do complete the projects (if everything goes according to plan). The average charge master review takes between 32 and 60 hours of work to completion depending on complexity of services and ancillaries. If it’s small, it’ll take less time; if it’s large it takes a bit longer.

Hospital charge masters can be all over the place. Most of them have way too many charges on them, and often they contain codes that have been expired for years or set up improperly. It’s no wonder; the average hospital has its charge master looked at by a professional once every 3 to 5 years. I’d thought that was an old statistic until I was reading a report that not only confirmed that’s still how it works but that some hospitals wait 7 years; ouch!

That initial time isn’t the only thing to be done; next comes the interviews. A lot of people have to be interviewed and that could take at least a week at a moderately sized hospital. It always depends on the availability of the people that need to be talked to. That’s because it’s not only about verifying that everything’s correct; it’s hopefully also about increasing revenue and reducing potential fraud… and a few things in between.


aroblesgalit / Pixabay

How well can this work? A charge master review can increase the revenue of some hospitals by more than 50%; yup, you got that right. That’s because a charge master review isn’t just a look at charges and codes, but a brief look at how charges are captured.

In a charge master review I did for a hospital in New Jersey in 2006, In about 30 minutes with one department I calculated that we increased their annual revenue between $2 and $5 million dollars. At another hospital we increased their revenue by more than 100% in a year; that was a long term project and even in that time period we left revenue on the table.

Of course, nothing happens if hospitals don’t follow through on the recommendations. If a hospital hasn’t had their charge master looked at in years, 50% is easily reachable; the normal average is around 30%, but even a 30% increase for a hospital generating $5 million a month already is pretty big dollars. I don’t charge anything close to that amount; if I could get just .5% new revenue I’ve generated over the years I’d already be retired. 🙂

Anyway, we’re still not done. After the interviews it’s back to the office, where it can take another 20 hours or so to write up the final report, and add any educational information a client might need. Then one last meeting, either in person or by telephone, and it’s finally complete.

Let’s see, that’s at least 100 hours of work over the course of 4 to 6 weeks. It’s a specialty service, one that not a lot of people do, so you’re not getting it for free; you’re also not getting it for $50 an hour. You’re getting it for probably way less than it’s worth over the course of time, but we’re not greedy.

Costly? Not really, but it can look like a lot at the time. Costly compared to the benefit? Not even close; hospitals win by miles.

Free? Ah, there’s the word again. No, it’s not free, and it’s not cheap either. Like everything else, hospitals get what they pay for unless they’re willing to do the work themselves. You can shop around and possibly find someone who’ll do it for less, but you still have to gauge that against all the other offers. If it’s drastically lower you have to ask yourself why.

Or maybe not. It’s something to think about if you’re at a hospital and haven’t had anyone looking at your charges in a long time. It’s also a smart thing to do if you’re unsure your revenue is being maximized.
 

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