Description

The hospital chargemaster is the backbone of accurate billing, reimbursement, and financial reporting, yet it remains one of the most complex and high-risk components of the revenue cycle. This session provides a practical overview of the hospital chargemaster and its critical role in supporting revenue integrity, minimizing denials, and ensuring accurate cost reporting. 

The session will explore the revenue integrity function and how it bridges clinical operations, coding, and finance to support compliant charge capture and sustainable revenue. 

The session will review the most challenging and high-risk areas for charge capture—such as supplies, infusions, emergency services, and ancillary departments—and outline strategies to strengthen controls in these areas.

Learning Outcomes

• Discuss Chargemaster Best Practices and Revenue Integrity Function 
• Evaluate how pricing and the chargemaster are connected. 
• Learn methods in managing chargemaster updates. 
• Identify high-risk charge capture areas within the chargemaster and implement strategies to reduce denials and compliance risk. 
• Analyze the impact of chargemaster accuracy on reimbursement, revenue integrity, and cost reporting. 
• Apply structured governance and oversight practices to maintain chargemaster integrity and sustainability. 
• Develop practical controls and cross-department collaboration processes to strengthen charge capture and prevent revenue leakage. 

Areas Covered in the Session

• Agenda
• Revenue Cycle Overview
• Why Focus on the Chargemaster Function?
• Core Functions
• The chargemaster and electronic health record environment
• Chargemaster
• Components of the Chargemaster
• Revenue and Usage
• Price Transparency
• Chargemaster Ownership
• Roles & responsibilities
  • The Clinician
  • Clinical Support
  • HIM/Coding
  • Revenue Integrity
  • Information Technology
  • Compliance
• Chargemaster Maintenance Roles & Responsibilities
• Policies & Procedures
• Ongoing maintenance
• Change request Process
• Additional Considerations
• Keeping the Chargemaster Current & Successful
• Additional best practices
  • Revenue Cycle Committee
  • External Coding/Billing & Charge Capture Reviews
  • Denials Workgroup
• Financial Considerations
• Reimbursement Methodologies
• Fee Schedules/APC/EAPG/APG
• Cost Report Revenue and Expense Matching
• Matching Expenses and Revenue
• Impact on Denials
• Denial Impact
• The Cost of Denials
• Optimizing denial prevention
• The Role of Revenue Integrity
• What is Revenue Integrity?
• Core Revenue Integrity Functions
• Reporting structure considerations
• Defining the revenue integrity scope
• Collaboration & Partnerships
  • Clinicians
  • Coding
  • Compliance
• Live Q&A Session, and many more...

Recommended Participants

• Revenue Cycle Directors and Managers 
• Revenue Integrity Leaders and Analysts 
• Chargemaster Coordinators 
• HIM Directors and Coding Managers 
• Compliance Officers and Auditors 
• Patient Financial Services Leadership 
• Finance and Reimbursement Managers 
• Cost Report Specialists 
• Clinical Department Leaders involved in charge capture 
• CDI Professionals 
• Internal Audit Teams