Charge Capture Optimization

02 Oct Charge Capture Optimization

Close Revenue Leaks. Boost First-Pass Yield. Pay Providers Faster.

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Why Charge Capture Matters

Charge capture is where clinical work becomes revenue. Every missed code, undocumented procedure, or workflow gap silently erodes margins. In multi-provider practices, leakage of 3–7% is common—often from small, repeated misses (missing modifiers, late entries, unbilled ancillaries, split/shared, global period errors, or device/procedure supplies not captured).

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Where Leakage Hides

• Documentation Gaps: Incomplete HPI/ROS/MDM, missing time, absent device/supply detail.
• Workflow Friction: Paper handoffs, post-it add-ons, end-of-day batching, late coding sign-off.
• Code Choices: Undershooting E/M levels, missing add-on codes, unbilled incident-to/split-shared.
• System Rules: Weak charge triggers, poor template logic, no edits for global bundling or NCCI.
• People & Process: Ambiguity around who codes what, and when.

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Financial Upside of Optimization

• 3–7% net revenue lift from captured but previously missed charges.
• 20–30% faster cash via higher first-pass acceptance.
• 15–25% fewer rebills as edits shift to point-of-capture.
• Cleaner payer relationships through consistent, defensible coding.

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Operational Benefits

• Standardized specialty playbooks (E/M, procedures, supplies, injections, diagnostics).
• Real-time prompts & edits inside workflows (not after the fact).
• Provider-friendly templating and smart phrases that “make the right thing easy.”
• Transparent dashboards for charge lag, first-pass yield, and missed-charge risk.

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Risks of Not Acting

• Silent revenue drain month over month.
• Rising AR days from preventable edits and rebills.
• Provider frustration (rework, addenda, back-and-forth with billing).
• Greater audit exposure if fixes aren’t systematic and traceable.

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How RPM Delivers Charge Capture Optimization

1. Baseline Forensics: 90-day lookback on charges vs. documentation vs. remits.
2. Signal Mapping: Identify missed ancillary/supply, add-ons, and pattern gaps by provider & payer.
3. Workflow Redesign: Build point-of-care triggers, edits, and smart templates by specialty.
4. Enablement: Provider coaching, coder calibration, and quick-reference cheat sheets.
5. Guardrails: Automated pre-bill validations and exception queues.
6. KPI Cockpit: Charge lag, first-pass yield, denial lift, ROI tracking.

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Project Details

• Type: Project → operationalized program
• Requirements: EMR/PMS access, charge rules, payer mix; sample notes & remits
• Step-by-Step:
  1. Baseline audit & opportunity sizing
  2. Build specialty playbooks & edits
  3. Configure templates/triggers in EMR
  4. Train providers/coders
  5. Go-live with KPI monitoring
• Timeline: 6–8 weeks to go-live; 90-day optimization cycle
• Expected Result: 3–7% revenue lift, ≥90% first-pass, ≤48h median charge lag
• Potential Setup Fee: Yes (scope-based)
• Duration: Project + ongoing monitoring
• Requires EMR Access: Yes
• Deliverables: Yes — playbooks, templates, edit library, KPI dashboards
• Ongoing Subscription: Yes — monitoring, refresh of rules, coaching

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Demand Heatmap

• Very High: Cardiology, Ortho, GI, General Surgery, Pain, Pulm, ENT (procedure & supply-heavy).
• High: Primary Care, Hospitalist (E/M leveling, transitional services).
• Growing: Telehealth, Remote Services (RPM/CCM/TCM add-on capture).

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Provider Satisfaction Metrics

• ↑ Documentation Confidence: 85–90% of providers report “clearer, faster” charge workflows.
• ↓ Rework: 20–30% reduction in addenda within 60–90 days.
• ↑ Throughput: 1–2 additional visits/day in clinic after template optimization.

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What Happens After You Sign Up?

1. Project is created automatically.
2. Assigned to a Project Manager (Account Specialist).
3. Client Portal is created for real-time tasks, documents, and progress tracking.
4. Intro/Discovery Call to confirm scope, data access, timeline, and go-live plan.

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IMPORTANT — Income Opportunity for Remote/Affiliate Sales

Product qualifies for a referral fee. Earn 15%+ per paid referral.

• For instant performance tracking, first sign up, then share your unique product link so customers pay through it.
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• Sign up: Easy Commission. Earn 15% Or More. Full Tracking
• 30-Day Refund Policy & Universal Terms: See Our Full Terms & Conditions

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Call to Action

Seal the leaks and turn clinical work into reliable revenue.
👉 Get Charge Capture Optimization from RPM below.

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