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CPI Experts - Services

Hospital CDManagement AdvantagePlus™

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The hospital charge master will ultimately determine your hospital’s success at compliance, systems integration, and cash flow. For many small hospitals, the most effective way to manage the dynamics and complexity of charge master compliance is to import the expertise of CDM specialists. This is why CPI Experts offers Hospital CDManagement Advantage Plus™, the comprehensive solution for hospitals who prefer to delegate the dynamics of CDM management to certified professionals.

With Hospital CDManagement Advantage Plus, CPI Experts becomes your CDM management team. Our professionals provide an accountable work plan for ongoing CDM development and maintenance. We fully utilize your existing staff while facilitating the code assignment, structure, and data flow analysis required to ensure Medicare billing compliance. Through scheduled education and just-in-time training, we work to improve the “CDM awareness” of clinical staff that interact with the CDM across department lines. We conduct periodic outpatient chart audits to diagnose potential lost charge opportunities that require intervention. We also assist management in understanding your charge process to determine where improvements are needed.

There are many compliance issues that go undetected in hospitals because no one has dedicated accountability for the charge master. With Hospital CDManagement Advantage Plus, we ensure that:

  • Charge items include proper HCPCS/CPT codes
  • Revenue code assignments reflect each service accurately
  • CPT/HCPCS codes are properly matched to revenue codes
  • Hard coded modifiers are assigned where required
  • Service structures are not improperly unbundled in violation with Correct Coding Initiative (CCI) or Outpatient Code Editor (OCE) edits
  • Transitional pass-through HCPCS codes for medical devices and pharmaceuticals are properly implemented
  • Charges exist for all services that are allowed under national Medicare guidelines
  • Pricing does not exceed levels that may constitute abuse
  • Redundancy and zero-charge items are eliminated

In addition to eliminating CDM issues, we work with HIM, IT, and clinical departments to resolve other revenue cycle issues. Our periodic chart audits help to highlight where better “hand-offs” can occur, such as eliminating mismatches between medical records and bills, or improving system interfaces that affect timing or accuracy of claims.

To provide long-term freedom from CDM issues, Hospital CDManagement AdvantagePlus is available as a 3-year or 5-year management contract. Let us show you how this approach may end up saving your hospital in terms of staff and lost revenue opportunity. More information >

Hospital CDManagement AdvantagePlus™

 

Year 1

Year 2

Year 3

Intensive CDM Evaluation

X

 

 

 

 

 

 

 

 

 

 

Monthly CDM Change Management

 

X

X

X

X

X

X

X

X

X

X

X

Education and Just-In-Time Training

X

X

X

X

X

X

X

X

X

X

X

X

Quarterly Outpatient Chart/Bill Audit

X

X

X

X

X

X

X

X

X

X

X

X

Benchmark Price Analysis

 

X

 

 

 

 

 

 

 

 

 

Department Charge Process Review

X

 

 

 

X

 

 

 

X

 

 

Implement Annual Medicare Changes

 

 

X

 

 

 

X

 

 

 

X

Monitoring and Reporting

X

 

X

 

X

 

X

 

X

 

X

Manuals and Documentation

 

X

 

 

 

X

 

 

 

X

 

CPI Experts On-site

X

X

X

X

X

X

X

X

X

X

X

X