Things a Chargemaster Coordinator Needs to Know

The Chargemaster is the code a hospital or physician’s practice uses to price procedures and submit them to insurance companies and clients for payment. This database needs to have the proper codes assigned to various line item services so that everyone knows what is being billed for and whether it is a good price for that service. The Chargemaster Coordinator oversees the team which oversees the maintenance of this database and has final approval for any additions and changes.

Chargemaster Maintenance

Maintaining the Chargemaster ensures that the items and services provided by the hospital or practice are properly priced and labeled for payment. If the codes are outdated, entered in wrong or underpriced, then the insurance companies and patients will refute the bills they receive. Regular charge review and update cycles are conducted by the Chargemaster team. This can be a tedious task without the right software. Luckily, solutions are available to help you track changes and check entries in real-time as well as streamline the review process.

Pricing Process

Each hospital has its own Chargemaster and the coordinator will meet with the procurement team, medical director and chief financial officer on a regular basis to determine to price. Each line item is assigned a code which is specific to the hospital or practice as well as a Healthcare Common Procedure Coding System or Current Procedural Terminology code. The HCPCS or CPT code is one that insurance companies will recognize as either something they cover or something that is the patient’s responsibility, so making sure that these are entered and priced correctly ensures that the invoice is paid without problems.

Billing Process

The billing and payment processes for medical procedures are complex and require the coordinator balance between charging too much for the insurance provider and patient to pay and charging too little for the hospital to cover costs. This means that the coordinator will work with the billing department over every invoice and help track down the origination of any errors which occur. Some of these inaccuracies can be as simple as a medical coding mistake and some can be more complex. A good way to ensure that errors happen as little as possible is for everyone involved in making the charts and invoices keep up with the changes in the Chargemaster and coding system.

In the medical industry, the role of Chargemaster Coordinator is an important one because he or she is responsible for a hospital or private practice being paid for services. The Chargemaster is a database with coded items and procedures along with their prices. You can find software to help review these prices and help streamline the process.

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