Impact Insights

Flossing for Dollars

You’re lying in your dentist’s chair for your semi-annual teeth cleaning and before the dental hygienist starts using that always enjoyable “Captain Hook” metal scraping tool, they ask – “Have you been flossing every day?” You answer, “Absolutely!” – lying right through your teeth (pun intended).

Of course, it doesn’t take long for your dental hygienist to realize you haven’t flossed since your last teeth cleaning six months ago – but hey, nobody’s perfect, right? Right.

I love to use this analogy with clients at hospitals and healthcare organizations to help them understand the important but often neglected daily task, charge reconciliation. Despite the importance of securing maximum revenue, charge reconciliation often gets overlooked, much like flossing. A recent Ingenious Med survey found 78% of respondents characterize charge capture as essential to their organization’s success, yet 40% of organizations discuss it only once a month or less! This is quite shocking given how important every dollar is to healthcare organizations and the potential revenue loss from neglecting charge reconciliation.

Where do we go from here? Unlike flossing, you can’t just decide one day to begin implementing a charge reconciliation process. However, in the same way your dentist can help you establish a healthy flossing routine, a charge specialist can help your organization get on track with charge reconciliation.

1.Charge reconciliation is an organizational commitment and therefore needs to be communicated from the highest level of your organization. Any plan you put in place will not succeed if the entire organization isn’t committed or held accountable and united in an effort to improve overall charge capture. Everyone is responsible and plays a part in charge reconciliation. Instituting an organizational policy can be a very effective way to clearly and unequivocally establish an expectation for the organization.

2.Charge reconciliation isn’t always an easy process. Ultimately, your goal is to make sure what was documented clinically was charged appropriately. It will take time developing a system that works within your organization and may involve a different approach within each department.

3.Charge reconciliation is an ongoing effort. In order to be successful, every department needs to complete charge reconciliation with frequent occurrence – ideally daily. This involves:

  • Running the posted charge report(s) every day, comparing the report to the clinical reports of the corresponding day, and verifying each patient was charged appropriately.
  • If a mistake is identified, the appropriate correction should be made within the patient’s record. This avoids any chance of lost revenue or delayed reimbursement from incorrect charging.

4.You’re going to have pushback. As I mentioned, you’re asking your clinicians and providers to do additional work, above and beyond their daily routine. Change never comes easy and is rarely accepted without a degree of frustration and growing pains. However, installing an accountable reporting structure system, such as weekly department status update meetings, will help ensure this initiative does not go undone.

Let’s get you out of the dental chair, and on the road to healthy flossing and charge reconciliation habits. If you don’t have a charge reconciliation system in place, begin those discussions as soon as possible – your organization’s livelihood depends on it!