Optimize Your Chargemaster

Payers’ “lesser of” charges can sap provider net revenue. This loss is 100% avoidable. Optimize your chargemaster to win full reimbursement.

When reimbursement shortfalls are 100% avoidable, providers must do everything to avoid them. Correcting an outdated chargemaster is an impactful way to prevent a common source of underpaid revenue from payers. 

An out-of-date chargemaster gives payers the opportunity to pay the “lesser of” rate – the amount stated in your chargemaster rather than the amount stipulated in the contract. When your contracts contain “lesser of” clauses, this lower reimbursement is fair game for payers, and aggravating for your team. 

With MD Clarity’s RevFind, you can find where chargemaster rates fall short of contract rates. Correcting these rates is a simple way to help you stem revenue leakage and chase down missed net revenue.  

Locate chargemaster / contract discrepancies

Too many healthcare organizations go a year or more before they update their chargemasters, leaving themselves open to “lesser of” clauses. 

RevFind reports find where “lesser of” clauses are triggered to guide your team in making chargemaster updates that lead to fair reimbursement. Identifying which codes and payers trigger reimbursement below contracted rates stem this source of revenue leakage.

Get oversight across your organization

Groups with many locations may need to wrangle a variety of practice management systems across their enterprises. Working across multiple systems can slow the revenue cycle team in identifying revenue leakage.

When data across your entire enterprise is consolidated into RevFind, you can review which of your locations are experiencing “lesser of” clauses. This information speeds up your analysis and gets remedies rolled out quickly.

Recoup the revenue you’ve earned

Understand which payers and procedures are triggering “lesser of” charges and prevent them before they occur. Reconcile chargemaster rates with contract rates to capture full reimbursement.
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