Charge Description Master (CDM) Compliance

Charge Description Master (CDM) Compliance is a critical metric in healthcare revenue cycle management that measures the accuracy and completeness of the Charge Description Master, which is a comprehensive list of all the services and procedures provided by a healthcare organization along with their corresponding charges. CDM Compliance ensures that the charges listed in the CDM are accurate, up-to-date, and compliant with regulatory requirements, such as Medicare and Medicaid guidelines. A high level of CDM Compliance is essential for healthcare organizations to ensure that they are billing correctly for the services they provide, avoiding underpayments or overpayments, and minimizing the risk of compliance violations. To achieve high CDM Compliance, healthcare organizations must regularly review and update their CDM, ensure that all charges are supported by appropriate documentation, and train their staff on proper charge capture and billing practices. By monitoring CDM Compliance, healthcare organizations can identify areas for improvement and take corrective action to optimize their revenue cycle performance.

Charge Description Master (CDM) Compliance is calculated by comparing the charges listed in the CDM to the actual charges billed to patients. This metric measures the accuracy and completeness of the CDM, which is a critical component of the revenue cycle management process.

To calculate CDM Compliance, the first step is to obtain a list of all charges billed to patients during a specific period, such as a month or a quarter. This list should include the charge code, description, and amount for each charge. Next, the CDM should be reviewed to ensure that all charges billed to patients are included in the CDM and that the charge codes and descriptions match. Any discrepancies should be noted and addressed. Once the review is complete, the percentage of charges in the CDM that match the charges billed to patients can be calculated. This percentage represents the CDM Compliance rate.

For example, if there were 1,000 charges billed to patients during a month and 950 of those charges were listed in the CDM, the CDM Compliance rate would be 95%. CDM Compliance is an important metric because it ensures that charges are accurately and consistently billed to patients, which can improve revenue cycle efficiency and reduce the risk of compliance issues.

Best practices to improve Charge Description Master (CDM) Compliance are:

1. Regularly review and update the CDM: It is essential to review and update the CDM regularly to ensure that it is accurate and up-to-date. This will help to avoid errors and ensure that all charges are captured correctly.

2. Establish a CDM governance committee: A CDM governance committee should be established to oversee the CDM and ensure that it is compliant with regulatory requirements. The committee should include representatives from various departments, including finance, coding, and compliance.

3. Conduct regular audits: Regular audits should be conducted to ensure that the CDM is accurate and compliant. The audits should include a review of charge capture, coding, and billing processes.

4. Provide training and education: Training and education should be provided to staff members who are responsible for maintaining the CDM. This will help to ensure that they understand the importance of compliance and are aware of the latest regulatory requirements.

5. Utilize technology: Technology can be used to automate the CDM maintenance process and ensure that all updates are captured in a timely manner. This will help to reduce errors and improve compliance.

6. Monitor and track performance: Performance metrics should be established to monitor and track compliance with the CDM. This will help to identify areas for improvement and ensure that compliance is maintained over time.

7. Collaborate with stakeholders: Collaboration with stakeholders, including physicians, nurses, and other healthcare providers, can help to ensure that the CDM accurately reflects the services provided. This will help to improve compliance and reduce the risk of errors.

The benchmark for Charge Description Master (CDM) Compliance is a widely recognized industry standard that measures the accuracy and completeness of a healthcare organization's CDM. The CDM is a critical component of the revenue cycle management process, as it contains all of the charge codes and prices for the services and procedures provided by the organization.

To achieve compliance with the CDM benchmark, healthcare organizations must ensure that their CDM is up-to-date, accurate, and complete. This includes regularly reviewing and updating charge codes and prices, as well as ensuring that all services and procedures are properly documented and coded.

The industry standard benchmark for CDM Compliance is typically set at 95% or higher. This means that healthcare organizations should aim to have at least 95% of their CDM codes and prices accurately reflected in their billing and reimbursement processes.

Achieving CDM Compliance is essential for healthcare organizations to maximize their revenue and minimize compliance risks. By maintaining an accurate and complete CDM, organizations can ensure that they are billing for all services and procedures provided, while also avoiding costly billing errors and compliance violations.

Overall, the CDM Compliance benchmark serves as a key performance indicator for healthcare organizations, helping them to measure their revenue cycle management effectiveness and identify areas for improvement.

Revenue cycle software can greatly improve the Charge Description Master (CDM) Compliance metric by ensuring that all charges are accurately captured and billed. With the help of automation and advanced algorithms, revenue cycle software can identify any discrepancies or errors in the CDM and correct them in real-time. This not only improves the accuracy of the billing process but also helps to reduce the risk of compliance issues.

MD Clarity's revenue cycle software is designed to streamline the revenue cycle management process and improve key metrics such as CDM Compliance. With our software, you can easily track and manage your CDM, ensuring that all charges are accurately captured and billed. Our advanced algorithms and automation tools help to identify any discrepancies or errors in the CDM, allowing you to correct them in real-time and reduce the risk of compliance issues.

If you're interested in seeing firsthand how MD Clarity's revenue cycle software can improve your CDM Compliance metric, we invite you to book a demo with our team. Our experts will walk you through our software and show you how it can help you streamline your revenue cycle management process and improve key metrics. Contact us today to schedule your demo!