Charge Master Reviews

The Charge Description Master (CDM) is an essential tool for organizational success. This ever-changing database needs continuous care. Even minor discrepancies can lead to significant reimbursement and compliance implications. Our Comprehensive CDM Reviews are designed to leave no stone unturned, with equally important commitments to revenue maximization and compliance. Using a combination of proprietary databases built upon regulatory guidance, and personal review by our expert consultants, an IRI Comprehensive CDM Review helps ensure that your CDM is complete, accurate, and compliant. Our CDM reviews include analysis of every active item in your CDM, including:

• Validation of all CPT/HCPCS codes assigned, including appropriateness of charge descriptions
• Identification of any items which are missing required CPT/HCPCS codes
• Identification of charges which may be missing from the CDM
• Validation of revenue code assignments, modifiers, drug unit multipliers, charge explosions, and alternate coding assignments
• Volume analysis to reveal trends which may indicate charge capture or other deficiencies
• Comparisons against Medicare, or other payer fee schedules
• Identification of potential compliance concerns related to CMS or other regulations (e.g., non-reportable services, self-administered drugs, unbundled charges, etc.)

After the preliminary review of the CDM, an IRI consultant will spend time on-site at your facility meeting with every clinical department to discuss initial findings, ask additional questions, and evaluate charge capture processes. Additional opportunities identified during this time will be incorporated into a final comprehensive report with recommended changes to the CDM and improvements to charge capture processes, accompanied by supporting documentation and spreadsheets. An exit conference can be scheduled to discuss findings with leadership.

Our assistance does not stop there. IRI is committed to the successful follow-through of our recommendations. Your personal consultant will remain available for any follow-up questions for six months after the completion of the review. Our goal is to provide you with the utmost confidence in the integrity of your CDM and charge capture processes.

IRI consultants have experience working with a number of different systems including Epic, Meditech, Cerner, CPSI, MEDHOST and others. 

If you would like more information, please contact us and we'll be pleased to discuss how we can help you.