Sunday, Jun 4, 2023

What Keeps Healthcare Costs Accurate?

It seems like everyone has been billed by mistake, or for the wrong amount by their health insurance company at one point or another. While these companies do their best to give us accurate bills, the fact is that there are so many moving parts and third-party vendors involved that this can easily get caught in a wild mess.

So how do healthcare providers and insurance companies keep the cost numbers accurate?

Most providers have what is called a chargemaster, which is the one that reviews and verifies costs. These costs are determined by widely used medical codes that help providers and insurance companies track and attribute certain costs to certain procedures. However, with millions of patients, addresses, and providers all having to be connected in order for billing to work, one wrong code can mess up the billing for a customer very easily.

Since it is impossible for a chargemaster to go through every single charge line by line, thankfully there are solutions that can help with this. One such solution is that of a cdm charge master. A cdm chargemaster can go through the databases of providers to review it line by line for inaccuracies when it comes to charge codes for supplies, procedures, and services. The beauty of technology like this is that it can take a manual task that would take weeks or months to do and can do it in mere seconds.

This lightning-fast process can quickly alert chargemasters at providers as to which items need manual attention in order to correct badly input medical codes and update them to ensure accurate charges and costs are affixed. This not only helps customers to get billed correctly, but it can help the providers to know if they are profitable or not, as well as better management of cash flow.