Self test unit 1

1. Chargemaster Toolkit™ replaces the need for coding and billing experience in the CDM CoordinatorAnother name for the supervisor function.

True or False?False

The Toolkit identifies situations that do not ‘appear’ to be consistent with coding and/or billing rules. Validation and appropriate judgment must always be applied to correcting or waiving each charge code flagged. Many factors outside the control of the Toolkit come into play including:

Local intermediary exceptions to standard coding practice

Provider intent (discrepancies between descriptions and HCPCS codes)

Clinical practice where potential compliance risks are identified

Service delivery models where potential missing ‘linked’ codes are identified.

2. I only need to review my Chargemaster once against the Toolkit to identify problems and opportunities.

True or False?False

Coding and billing rules change frequently. New information is periodically incorporated into the software updates every 7 to 10 days. Any time a new service is added the Toolkit should be used to assure proper coding prior to updating the CDM. Information regarding compliance risks, new services, etc are also continually updated in the Toolkit. To fully maximize your return on investment and improve your workflow and system of accountability we recommend the Toolkit be the primary workbench for all day-to-day CDM maintenance.

3. Anyone can perform software updates.

True or False?True

There are number of options available to assist you with the update process. Each user must upgrade when prompted but only the first user need download the upgrade from the Craneware web site. The Active UpdateA feature of the Chargemaster Toolkit that ensures that you always have the latest version of the software and the coding information process is designed to be a simple process requiring only a few mouse clicks.

4. I can run the software with only a subset of my CDM data fields.

True or False?True

There are a limited number of fields required for the software to function. These include service codeA facility’s unique identifier for a charge item, Department code, description, revenue codeRevenue codes standardize the financial groupings of the services that are performed health care providers. Each revenue code consists of three digits, which identify standard cost center. A revenue code should be assigned to each charge item and HCPCS codeHCPCS (HCFA Common Procedural Coding System) codes are used by healthcare providers and medical suppliers to report professional services, procedures and supplies. Each code is a 5-character alphanumeric code. All other fields are optional but are often useful to make the Toolkit a more powerful analytical tool, make CDM information more accessible to operations management and use the Toolkit as the primary workbench for all CDM edits.

5. Only data from my billing system CDM may be included in the Toolkit.

True or False?False

Any data element you can extract from your system and match with a unique service codeA facility’s unique identifier for a charge item in the CDM table can be incorporated into the Toolkit. The provider is responsible for designing and implementing a routine, reliable process of creating the data extract each month for the merge process.

6. The Toolkit recognizes payer-specific revenue and HCPCS codes.

True or False?True and False

Though Chargemaster Toolkit™ is primarily a Medicare Outpatient auditing tool you may opt to include details for more than one payer in your CDM. Where multiple payer-specific fields are present the Toolkit will audit each charge itemA service or procedure for which your facility will charge. In a CDM file each charge item usually comprises of a service code, a short descriptive field, a CPT code or HCPCS code, a GL code and a revenue code based on the first populated payer field in the order you specify. Please note however that regardless of the payer, the audit will primarily be Medicare Outpatient based.

7. I can change my file layout at any time.

True or False?True

We anticipate that situations may arise whereby adjustments to your file layout may become necessary to accommodate your ongoing requirements. Most adjustments such as changes to existing fields or the addition of new fields can be made with minimal disruption (although some more complex changes may impact on your audit trail history). Although Craneware reserve the right to make an additional charge for modifications to your template, such charges would only arise should changes to your template become frequent.

8. The Toolkit production file replaces my billing system CDM.

True or False?False

The Toolkit audits a copy of your billing system CDM data.  Providers may choose to continue making direct edits to the billing system, and/or forget to record changes made in the Toolkit file on the billing system table. To prevent divergence of the data from the two systems, a merge process is available which will assist you, ensuring synchronization.

9. All users of the Toolkit will have full access to the Chargemaster data.

True or False?False.

It is possible to control user access to the Chargemaster Data in many ways. The Toolkit will allow the supervisorThe person who is designated to liaise with Craneware Inc. The person with primary responsibility for a particular HPT file to specify access only to departments they need to edit and if required this may be further restricted to view the data only. Alternatively, some users may have no access to the Chargemaster through the Toolkit but may be provided with access to Craneware Online. This provides full access to the powerful suite of reference materials and e-mail communications with the Toolkit users, but with no access to the CDM data itself.

10. All changes initiated in the Toolkit can be tracked and exported to a file that automatically updates my billing system CDM.

True or False?True

There are two options for electronically updating changes made in the Toolkit to your billing system. The most efficient method is through the Interface Scripting Module which directly updates your billing system. Alternatively, you may export the modified charge items from the Toolkit to a file to your specification. This file may be scripted to your billing system using your own upload process. Both methods are supported by a date sensitive implementation filtering tool that identifies approved transactions ready for updating.

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Craneware Inc.
Installation and Training
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Suite 102
Orlando Florida 32822
Telephone: 888 601 4162
Fax: 407 384 9413
E-mail: training@craneware.com
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