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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.
Charge Master Reviews
Charge Master Reviews

The Charge Description Master (CDM) is an essential tool for organizational success. CDM reviews ensure complete, accurate, and compliant Charge Master files.

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Charge Mapping
Charge Mapping

Experience has shown that having a clean and accurate CDM doesn't always translate into the correct charges being generated 100% of the time.

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Revenue Integrity Audits
Revenue Integrity Audits

Revenue Integrity Audits identify opportunities or deficiencies by analyzing the flow of charges from the point of order through to third-party adjudication.

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Annual Retainer Service
Annual Retainer Service

Researching important matters related to regulatory guidance, billing, coding, and reimbursement can be a full-time job. IRI consultants can save you time.

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On-site Training
On-site Training

IRI consultants are available to perform on-site training for your Revenue Cycle Staff. Our training programs are developed based on your requirements and needs.

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Educational Workshops
Educational Workshops

IRI educational workshops are regularly presented in an easy to understand format. Attendees bring back comprehensive manuals for future reference.

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Annual CDM Impact Analysis
Annual CDM Impact Analysis

Updating your CDM and associated systems in an accurate and timely manner is essential to avoiding billing delays, denials, or improper reimbursement.

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Remote CDM Management
Remote CDM Management

Ensure sustained accuracy and compliance via remote CDM management or support. The level of engagement of our consultants depends upon your needs.

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Price Transparency

Price Transparency is now a requirement for hospitals. To avoid fines, hospitals need to produce a Machine Readable File (MRF) of all payer and plans reimbursement terms.

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Request A Complimentary CDM Checkup

TESTIMONIALS

“As a Critical Access Hospital undergoing conversion to Epic, we needed assistance in moving to the new platform. We engaged IRI for their Charge Master Services and were delighted with all aspects of their work. They are abundantly professional and quickly built confidence in their expertise with all of the teams involved in this project.  The requests that we had of them ranged from Provider Based billing, to Operating room, to Pharmacy among others.  We had a tight timeframe and they fit us in with supreme customer service and responsiveness.  We will definitely use them again for future projects, as well as some ongoing services. So grateful to have found this wonderful group of Charge Master experts.”
Thersea TaborCFO Family Health West
"The Concord Hospital Revenue Integrity department engaged IRI to perform comprehensive CDM Reviews for all our facilities and service lines.  We chose IRI, because unlike other firms, they commit to analyzing every single charge line.  They delivered on that promise.  The reports and files they returned were comprehensive, easy to understand, and thoroughly explained potential issues and opportunities.  We also use the IRI Retainer Service to assist us in understanding complicated charging and billing rules as they come up.  Jon and Julie are extremely knowledgeable and helpful. I highly recommend their services."
Erin Cutter, MBA, CPC, COC, CHRIDirector of Revenue Integrity, Concord Hospital
"We are incredibly satisfied with the exceptional Revenue Cycle services provided by Integrated Revenue Integrity (IRI). Julie Hall and her team demonstrated unmatched expertise, professionalism, and a commitment to exceeding our expectations. Their proactive approach, clear communication, and dedication to customer satisfaction made a significant positive impact on our project. IRI truly stands out in the industry, and we highly recommend them for top-notch service."
Matt FeidDirector or Revenue Cycle, Sturdy Memorial Hospital
I would highly recommend IRI in an interim management capacity; they filled a critical staffing gap and performed much needed analysis on claims and denials. They took time to understand the objectives that were important to our revenue cycle and worked to target those areas of concern. When changes were recommended, they included well researched payer policy, supporting documentation, and alignment with industry best practice. Julie integrated seamlessly into the department, effectively worked with operational stakeholders in our organization, and assisted with knowledge transfer for the incoming manager to ensure a smooth transition. Julie’s leadership and expertise were valuable; we will utilize IRI should another need arise for interim management.
Tricia StephenDirector, Patient Financial Services
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Integrated Revenue Integrity (IRI) provides an integrated suite of solutions to ensure that your facility is maximizing reimbursement in compliance with regulatory guidance.
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