RIMR offers a Desktop Chargemaster review of your Hospital CDM to validate all services, supplies and pharmacy items against the current Medicare Addendum B to ensure an accurate and compliant chargemaster:

  • Chargemaster Review of CPT/HCPCS, Revenue Codes and associated descriptions

  • Modifier Review for accuracy

  • Revenue Code assignment appropriateness

  • Hospital pricing review against Medicare APC and Commercial Payor Fee Schedules if requested

  • Pharmacy Dosage Calculator units against Medicare Drug HCPCS description unit of measurement

  • Identification of price discrepancies for “like” services

  • Facility Price review against Medicare APC x 2.5

  • Provide Medicare coding and compliance comments

  • Review of findings with Facility

  • One Year of Unlimited Questions to Your Consultant to ensure implementation success

 

Chargemaster Review

 

  • Accuracy of CPT/HCPCS against the current Medicare Addendum B codes and descriptions of procedures, supplies and drugs in all hospital departments

  • Review Modifiers listed in the hospital Chargemaster to determine appropriateness or those that may be missing, based on Medicare Correct Coding Guidance

  • Revenue Codes assignment associated with the service, drug or supply based on the current Uniform Billing Editor 

  • Pharmacy dosage calculator based on hospital billing system and Medicare HCPCS code to ensure the dispense amount is accurately reflected in the final bill

  • Hospital pricing review against Medicare APC or Medicaid (Commercial Payor rate review also provided if requested)

  • Identification of price discrepancies for “like” services 

  • Provide Medicare coding and compliance comments relative current Correct Coding guidance

  • Review of findings with Facility to ensure successful implementation

 
 
 

One Year of Unlimited Questions to Your Consultant

 

  • The hospital managers, PFS, HIM, CFO and CDM Coordinator may contact your consultant with questions relative to the Desktop Chargemaster findings.