What is a chargemaster in healthcare?
A chargemaster serves as a medium between a healthcare facility and for billing their patients and insurance companies. This system contains a list of all the billable services and/or items to a patient or the patient’s insurance company.
What is the purpose of a charge master?
The chargemaster typically serves as the starting point for negotiations with patients and health insurance providers of what amount of money will actually be paid to the hospital. It is described as “the central mechanism of the revenue cycle” of a hospital.
What is a chargemaster and why is it important?
For hospitals, an accurate and up-to-date chargemaster is the backbone of this type of revenue flow, as well as an important record for purposes of public reporting and compliance. An unreliable chargemaster will lead to revenue leakage, legal liabilities, and even confusing and high charges for patients themselves.
Who is responsible for updating charge masters?
Hospital administrators are responsible for updating chargemasters.
How are Chargemasters generated?
When a patient receives services from a hospital, providers document the encounter in the medical record and health information management staff or professional coders assign codes for reporting and claim submission. Those codes and documentation are translated via charge capture to chargemaster rates.
What is the charge master rate?
Patients without insurance are automatically billed the chargemaster rate, which is, in many cases, highly inflated (the average is 4x the actual cost). As a result, many hospitals will offer discounts and lower rates to uninsured patients, to bring those costs down to a more realistic and manageable level.
Can a hospital have multiple Chargemasters?
What’s important is the term “hospital specific,” which means that each hospital has its own chargemaster, and each one is different. This can make it incredibly difficult for a patient to try to decipher a hospital bill. It also leads to wildly varying prices for services.
What does outpatient mean in health insurance?
An individual (patient) who receives healthcare services (such as surgery) on an outpatient basis, meaning they do not stay overnight in a hospital or inpatient facility.
What are the benefits of outpatient care?
What are the benefits of choosing outpatient services? Outpatient services usually cost less, because you don’t need to stay overnight. Staff members at outpatient centers are well trained in the service they provide. Most of the time, these centers specialize in one kind of treatment or procedure.
How much does an outpatient visit cost?
The average outpatient visit in the United States costs nearly $500, according to a new scientific study by the Institute for Health Metrics and Evaluation at the University of Washington. In addition, the average inpatient stay had a price tag in 2016 of more than $22,000.
What does a chargemaster mean in health insurance?
In the United States, the chargemaster, also known as charge master, or charge description master ( CDM ), is a comprehensive listing of items billable to a hospital patient or a patient’s health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital.
Where can I find the chargemaster for my Hospital?
Federally all hospitals are now required to post their Chargemaster on the hospital website. Hospital price transparency helps Americans know the cost of a hospital item or service before receiving it.
What is the role of the hospital charge description master?
The hospital charge description master, or hospital chargemaster, is at the heart of the healthcare revenue cycle, serving as the hospital’s starting point for billing patients and payers. A hospital chargemaster is a list of all the billable services and items to a patient or a patient’s health insurance provider.
What do you need to know about the chargemaster?
Description. Chargemasters include thousands of hospital services, medical procedures, equipment fees, drugs, supplies, and diagnostic evaluations such as imaging and blood tests. Each item in the chargemaster is assigned a unique identifier code and a set price that are used to generate patient bills.