Charge entry is one of the key aspects in medical billing. In very simple word we can describe charge entry as the process of entering details to fill out CMS-1500 / UB-92 to submit it to the insurance for reimbursement purpose.
What is Charge Entry?
Charge entry in medical billing represents the meticulous translation of healthcare services into coded entries for billing purposes. It goes beyond mere data entry; it is a meticulous process where each service, from routine check-ups to intricate surgeries, is carefully recorded to ensure that billing accurately mirrors the care provided. This process taken place after coding team assigned appropriate dx-code, CPT code, modifier, place of service code and so on. Coders are generally transmitting all these information on any of documents like: fee slip, supper bill, charge master sheet, day sheet, encounter etc. These documents are either some sort of sheet (physical forms) or electronic form to transmit the information into the billing software. In case of physical form, provider needs to enter every details manually such as appropriate CPT code, dx-code based on the patient’s illness, and all other sort of information like: POS, Modifier, Units, and so on and so forth. Then, they need to scan and forward it to the billing department. Whereas, in case of electronic form, the same details are keyed, but that data can be automatically transmitted into the software.
Billing team is not acting just like data entry team. They must be well educated and experienced into the field of medical billing. They must know all in and out of providers specialty for which they do charge entries. So, once they have received any super bill from the provider or from the coding department, it become their responsibilities to verify all the details based on the medical notes/treatment notes and make sure that the information they have received on supper bill are accurate.
In addition to that, charge posting person must have in-depth knowledge about all aspects of billing. Meaning, they should know what are the required modifiers are. Which should be the Primary dx-code and which one is Secondary. Which one is addon code to main procedural code. Which POS is accurate based on the patient’s visit.
We need to understand the meaning and the definition of commonly used elements during the charge entry process.
Diagnosis Code: Diagnosis code defines the details of Illness of the patient. It is also known as DX code in medical billing.
Procedure Code: Procedure code describes the services or treatment provided by the doctor or hospital.
Modifiers: Modifiers is used with the procedure codes in order to differentiate one medical services with the other rendered to the patient.
Date of Service: Date of Service is the date when the patient was treated by the health care provider.
Units of service: It indicates the quantity of health care procedures of the claim in medical billing.
Authorization number: Authorization number also known as prior authorization number or pre certification number. Provider has to take an approval from the insurance company before the patient receives the health care services.
Billed amount: Billed Amount also known as charge amount. It is the amount charged for each service performed by the provider and entered at the time of charge entry.
Super Bill: Super Bill is a standard form which includes procedures, diagnosis codes, patient and insurance details, and visit related details like: date of service and co-payment. This document also known as face sheet, fee slip, charge master sheet, day sheet, and encounter notes.
By achieving utmost accuracy in charge entries, healthcare providers can unlock their financial stability, build trust with payors, and enhance patient satisfaction level. It is a significant part of the medical billing process that is often neglected but impacts a healthcare organization’s revenue potential and cash flow. We, at Ingenious Outsourcing understand the importance of accurate coding and billing to generate steady and higher cash inflow for providers. As we believe, we are the safest and very promising in entire RCM process. So, do not hesitate to put your billing into the safe hands.