7 minute read

Charge Capture: Optimizing Revenue Cycle Efficiency in Healthcare

Kelsey Zaporowski

Updox Content Writer

Uncategorized

The average healthcare facility loses 2% to 3% of its annual revenue because of preventable leaks. That’s right—preventable.

If your practice is like most, tweaks to your billing process could deliver an immediate 3% increase in revenue.

How would your practice improve because of this? Could you do more to meet patient demand? Could you invest in new equipment? Could you achieve better health outcomes?

These are inspiring thoughts to consider. But if you want to turn this quick-win revenue boost into a reality, you need a practical strategy. You need a plan that tackles revenue cycle challenges head-on.

Start with charge capture.

What is charge capture in the revenue cycle? We’ll unpack this question and more below.

We’ll explain what charge capture is and why it’s central to your practice’s financial health. We’ll look at the importance of optimizing it and the outcomes you could achieve.

Finally, we’ll share some ways you can start the process today.

This is your guide to getting paid for every service you provide. Your financial sustainability depends on it.

What Is Charge Capture in the Revenue Cycle?

Charge capture is about recording every service provided to patients. Then, it’s about collecting payment for those services.

Think about it like this: If a service isn’t captured, it isn’t billed. If a service isn’t billed, you lose money.

Let’s say you have a patient come in for a routine check-up. But during the visit, the doctor and patient decide an additional service is needed.

If this additional service isn’t recorded, the patient may only pay for the check-up. But the doctor spent time and resources on the extra service—all of which are not compensated.

This is why charge capture is so crucial to the revenue cycle. If it’s not built into the process, there’s no guarantee you’re being paid for the services rendered. This results in significant and avoidable revenue loss.

The Charge Capture Process

How does the charge capture process unfold? Here it is, step-by-step:

Step 1. The patient registers for their appointment. Your practice collects their insurance information, which is then verified. You now have the details needed to bill the patient and their insurer.

Step 2. During the patient’s visit, the services provided are documented. This means all services, from consultations to procedures. An electronic health record (EHR) system can be a huge help during this step. It automatically and accurately records the services.

Step 3. The services then enter your billing system. Each service corresponds with a charge code. You use this code to create the bill. Mistakes at this stage can be costly. The wrong codes or too few codes lead to claim denials and underpayments.

Step 4. Next, your billing system generates a claim. This is sent to the insurer or payer.

Step 5. When the claim is processed and approved, the payer will send the payment to your practice. You will then post these payments to the patient’s account.

Step 6. Sometimes, claims are denied. Others are only partially paid. There could be errors in the charge capture or codes. Or, the insurance information might be incorrect. You’ll need to investigate the denial, make corrections, and resubmit the claim.

Step 7. If there’s a balance left over after the insurance payment, you can bill the patient.

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Importance of Optimizing Charge Capture

A healthy and efficient revenue cycle doesn’t just benefit from accurate charge capture. It depends on it.

For example, say your practice introduces telehealth appointments. You’re committed to healthcare access and ready to expand your reach.

A patient takes up your new service. During a virtual consultation, the patient is diagnosed and prescribed a treatment.

They are thrilled with their experience, but it’s not all sunshine. The telehealth consultation was not accurately documented. The charges weren’t captured in your billing system, so you miss out on the revenue.

It’s a realistic scenario, one that might happen daily or a few times a week. Either way, the lost money adds up.

All of a sudden, your practice is suffering from significant financial loss. This is impacting your service quality and staff morale.

In contrast, optimizing charge capture makes sure that your practice is paid for every single service it provides. Your revenue reflects the care given to your patients.

In addition, accurate charge capture means fewer denied claims. This leads to faster payments and less time chasing patients for more information and resubmitting claims. In an environment where resources are already stretched thin, this is a huge win.

3 Ways Charge Capture Improves Patient Satisfaction

We’ve investigated the advantages from a financial perspective. But what about care quality?

Here are three benefits that uplift patient satisfaction:

Benefit 1. Your practice has fewer billing errors. According to NBC, “Medical billing errors are a common problem that can be extremely costly for consumers.” But with accurate charge capture, patients are billed fairly. There are no surprises, which builds trust. They know they can count on you to give them accurate bills.

Benefit 2. Payments are processed faster because insurers are less likely to deny accurate and complete claims. You get paid sooner, which empowers you to make informed investments that improve patient care. For example, you might budget for new medical equipment knowing you have reliable cash flow to cover expenses.

Benefit 3. You can reallocate resources to patient-facing tasks. Instead of fixing and resubmitting claims, your team can work on improving practice operations. They have the mental bandwidth to innovate, problem-solve, and show genuine compassion.

Common Challenges in Charge Capture

Charge capture is extremely beneficial. So why is it a source of lost revenue for so many healthcare practices?

Here are some of the most common challenges preventing optimized charge capture:

Coding errors result in underpayments and claim denials.
Delayed data entry can mean deadlines get missed. Claims are submitted before they’re complete.
Missing details and incomplete documentation make it nearly impossible to assign the right codes and capture all charges.
Staff might not know how to apply medical codes properly. They might not be aware of the importance of charge capture, so they let things slide.
Your systems might not be properly integrated. Data transferred from one system to another isn’t accurate, up-to-date, or complete. This causes you to miss charges.

How do these impact your finances?

You earn less revenue. Simple as that. This can put a real strain on your budget.
More of your claims are denied by payers. Your team needs more time to correct these mistakes.
Your cash flow becomes inconsistent. It gets harder to forecast revenue, make budgets, and manage your expenses. Investing to improve your practice feels like a pipe dream.
Less revenue means less profit. Less profit means you’re unable to reach growth milestones.
Your finances are unstable and unreliable. This causes stress. It makes general business management more complicated than it needs to be. It takes the focus away from what’s most important—supporting the health and wellness of your patients.

Strategies to Optimize Charge Capture

You can overcome these challenges and avoid the financial repercussions.

Here are four ways to optimize your charge capture process and bring in every dollar you earn.

1. Adopt Real-Time Charge Capture

Charge Capture seamlessly record patient notes, billing codes, and rounding lists at the point of care.

A Charge Capture app allows providers to promptly and precisely record charges right after patient visits, optimizing revenue without delays from handwritten notes submitted days later or misplaced.

2. Invest in Staff Training

Charge capture processes and medical coding are core skills your staff needs. Give them the tools to help you succeed.

Schedule refresher training sessions to remind them about charge capture and how it fits into their day-to-day. Be practical and realistic with your guidance.

Update them on coding changes, too. That way, the claims they submit become more accurate, which can decrease denial rates.

3. Conduct Regular Audits

You can’t fix what you don’t know. So, perform routine audits of your billing process, including charge capture.

Examine the data to uncover key trends in missed charges or coding mistakes. Flag errors and identify areas where improvements can be made.

Do this regularly—every three months or so. That way, you can correct issues sooner rather than later.

4. Upgrade Your Software

Maybe it’s technology that’s holding you back. Consider upgrading to a truly integrated system, one that links practice management, EHRs, and billing

Charge capture is a comprehensive system that bridges the workflow gaps by connecting practice management, EHRs, medical billing, and charges, enhancing efficiency and accuracy in capturing and managing healthcare charges.

With this setup, data can flow between the systems without becoming inaccurate. You don’t have to rely on manual data entry. This reduces the risk of lost or incorrect charges.

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How You Can Start Optimizing Your Charge Capture Right Now

Ready to improve your charge capture process? Try these four tips:

Assess your practice’s needs. Look at your current charge capture process. Identify areas where you may be losing revenue, such as missed charges or delayed billing.

Flag bottlenecks in your workflow. Identify steps in your operations that slow down charge capture. Is data entered late? Are codes often wrong? Address these bottlenecks with new technology or staff training.

Consider real-time charge capture. Think about whether real-time charge capture methods would work for your practice. Weigh the benefits of manual and tech-driven charge capture.

Research integrated software solutions. Integrate your practice management system with your EHR and billing software. If this isn’t possible with your current provider, it might be time to look elsewhere.