GRMC approves charge master review

The Graham Regional Medical Center board approved a third-party charge master review last week which will fine tune their billing process and charges.

BKD, the company which performs the hospital’s audit, provided a quote for between $67,000 and $70,000 for a charge master and charge capture process review.

“The first phase will be a compliance desk assessment,” CEO Shane Kernell said. “We will provide them a copy of our charge master, they will do some compliance assessment of it. Check for proper description, proper code, is the charge within line?”

The CEO said this process has not been done since Endeavor Healthcare took over as the hospital’s management company years ago.

“What BKD will do is look at, ‘hey, you did an EGD with a biopsy, did you charge for an EGD with a biopsy or did you charge for a diagnostic EGD?’” Curtis Rojas, president of Endeavor Healthcare, said. “They want to make sure that you have all the correct codes in the system and you don’t have any (codes) that aren’t valid anymore. Medicare changes them every year.”

Kernell said where it has importance of what you charge is for private insurance companies because they have contract language where they will pay the hospital the price agreed upon or the charge, depending on which one is less.

They will then conduct focused departmental interviews, where they focus on five clinical departments; the emergency department, operating room, infusion therapy, lab and high-dollar imaging.

The final phase, will be a charge capture review, where the CPA firm reviews how the hospital captures things operationally so they can bill it and be paid for it.

For the rest of the story, see the Wednesday, July 31 edition of The Graham Leader.