Chargemaster, Charge Capture and Price Modeling Solutions with nThrive

Comprehensive revenue capture, cost recovery and defensible pricing are all essential for today’s health care organization to thrive. nThrive offers revenue cycle management solutions to ensure compliance, meet Price Transparency requirements and raise revenue cycle performance.

Charge Description Master (CDM)

What does a strong Charge Integrity Program look like? A high performing program includes across-the-organization revenue capture, cost recovery and defensible pricing. Turn to the full suite of nThrive revenue cycle management solutions to ensure compliance, meet Price Transparency requirements and raise revenue cycle performance.

The chargemaster - or charge description master or CDM - is the heartbeat of your health care organization's revenue cycle and performs its best when it is diligently maintained, providing an accurate and compliant source of truth. A strong CDM can manage thousands of continually changing charge items and regulations that adversely impact pricing, revenue, costs and credibility. But what if your organization is challenged by limited staff and resources? How can the CDM stay strong?

nThrive delivers a complete, web based CDM that covers inpatient and outpatient charge items for the entire CDM to mitigate cost recovery, accurate charging and compliant pricing issues. Use nThrive optimized CDM technology and services to:

  • Achieve all-inclusive revenue and cost capture for the entire CDM, coded line items and beyond
  • Benchmark pricing for more than 390,000 charge line items with nThrive Preferred Practice Model. Includes proprietary line items for surgery, pharmacy, supplies, procedures and time charges
  • Prevent revenue loss with technology that identifies invalid CDM codes
  • Ensure chargemaster accuracy through daily alerts on new coding changes, including interpretation and suggested actions for compliance by the nThrive clinical team
  • Gain insight from monthly reviews, and compare your CDM to nThrive Preferred Practice Model to flag and resolve discrepancies
  • Automate manual processes, such as change requests, to keep your CDM up to date and synchronized across multiple facilities, and compliant with corporate standards
  • Increase operational efficiency with integration on all leading patient accounting systems (PAS)
  • Address regulatory questions through two options: 1) Alerts for new informants that provide a summary of regulatory changes and a link to further documentation 2) Utilize Coach to ask questions and receive guidance from our clinical experts

Maricopa Medical Center gains net revenue improvement of $17.5 million with Patient Access and Charge, Pricing and Compliance Solutions from nThrive

nThrive helps Maricopa Medical Center update its chargemaster for accuracy and compliance, and improves revenue and enables defensible pricing

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Charge Capture Audit

A good charge capture audit system catches missing charges, over charges plus medical billing and coding errors that threaten to create revenue and compliance issues – including penalties for charge overages.

nThrive Charge Capture locates lost revenue from missed charges and coding errors by automating audits for inpatient and outpatient charges, reduces risk of billing overcharges, plus identifies and fixes compliance issues pre-bill. It stops costly rework and late charges through the automation of audits.

We offer technology and consulting services that provide the insight to create sustainable process improvements that assist your organization to:

  • Increase average net revenue and identify millions in missed charges with nThrive comprehensive charge-level auditing, encompassing 12,000+ rules and predictive analytics
  • Ensure timely compliance on new regulations through the credentialed team of nThrive clinical experts who analyze and deploy new auditing rules on effective dates
  • Increase accounts receivable and avoid A/R delays with nThrive workflow processes that route exceptions to the best professional for pre-bill resolutions based on your health system criteria.
  • Overcome resource constraints and recover lost charges – pre and post-bill – through nThrive outsourcing services

Gwinnett Hospital System identifies $16.3 million in net financial improvement

Gwinnett Medical Center uses nThrive Charge Capture Audit solution to improve net revenue by $1 million in first year, increasing to $16.3 million over time

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Integrate EMR and Charge Capture solution to reduce late charges, extend resources

Reduce late charges and extend your resources through integration of CCA with leading EMR

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Health Care Price Modeling

Price management and modeling are essential to revenue and cost recovery, competitive advantage, compliance on pricing transparency regulations and the ability to provide accurate estimates for consumers and patients.

The nThrive modeling solution can help you achieve incremental net revenue to offset shortfalls brought about by APCs and removal of "non-covered" Medicare charges. Providing defensible pricing at the line item, department and facility level, and showing impact on managed care stop-loss contracts, empowers your organization to:

  • Use the nThrive flexible modeling methodology to set multiple pricing parameters, deploy cost mark-ups and apply competitive rules at the CPT® and clinical service level
  • Gain a higher level of cost-to-pricing accuracy, enhancing your revenue cycle through nThrive proprietary pricing benchmarks that include inpatient and outpatient services, supplies and drugs
  • Achieve incremental net revenue and realize returns of $300,000 to $5 million in incremental net revenue ‒ depending on hospital size, payor mix and pricing parameters – often with no overall hospital price increase.

Health care pricing strategy: Where to begin

Read the nThrive executive guide to learn how to identify key pricing objectives, define what to look for in a partner and determine modeling options.

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