Selecting Data fields

Chargemaster Toolkit™ has the ability to support at least three independent but related business objectives including:

1. Continuous auditing of billing data for compliance with Medicare rules.
2. CDM maintenance workflow management.
3. Revenue analysis.

Beyond the data fields required to perform the CDM audit you have almost unlimited flexibility in including other fields from the billing system CDM, financial reporting system and decision support systems that relate to specific billing code activity.

Options checklist: 

1. I want to maintain my entire CDM in the Toolkit including all data fields and records.
2. I want to include payer-specific revenue and HCPCS codes or records.
3. I want to include prior year and year-to-date volumes to allow trend analysis.
4. I want to include supplier reference codes from the materials management system.
5. I want to include multiplier information from my pharmacy system.
6. I want to include relative work values for some but not all codes.
7. I want to include productivity and/or cost standards.
8. I want to include outpatient prices from key contracts.
9. I want to include cross-references to other order entry systems that contain the same code.
10. I want to include non-revenue producing (aka statistical) codes I use for analysis or cost tracking.

Key information and lessons from the field:

• We strongly recommended that you develop a reliable extract process routine for periodically (usually monthly) synchronization with the Toolkit using the merge function.
• Consider exactly how you wish your hospital file to look when loaded into Chargemaster Toolkit. The Toolkit will display your data just as it appears in your CDM fileAbbreviation for Charge Description Master file (also known as the Charge Master file). This is the file that comes directly from the facility and which describes the Charge Master. It can be any format and it must be converted to a HPT file (hospital file) before it can be loaded into the Chargemaster Toolkit but remember that your screen will only display a limited number of columns of data at any one time. It is advised that you place similar data in adjacent columns. Users may move or hide columns to customize the display to their own specifications.
• Users with edit authority will be able to modify any field (including informational fields) contained in the Toolkit. All modifications are fully documented in the audit trail together with the user’s ID.
• Edits to payer-specific HCPCS and revenue codes can be easily managed and documented in the audit trail.  Where multiple payer 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 on the Customization Agreement Form. Please note however that regardless of the payer, the audit will primarily be Medicare Outpatient based. By including payer-specific values in the CDM file you can consider the implications of any Medicare coding changes on them more easily.
• Centralized tracking and documentation of all CDM edits through the Toolkit is optimal when possible.
• Linking vendor information to your supply codes in the data file can assist operations managers and the CDM maintenance team in better matching descriptions to the intended supply item. In this way the accuracy of your charge capture process will be improved and future maintenance more efficient.
• Include multiplier information from your pharmacy system to allow verification that appropriate dosage is being billed when intent of service issues are flagged.
• Ensure routine updates to any informational data fields are incorporated into the monthly data extract so that the information is reliable.
• To ensure supporting charge entry systems and documents also reflect adds, deletes and description modifications you may wish to include additional fields that reference each table tied to a charge code. In this way you can quickly filter and report changes to these system administrators for action.
• Some clients use their charge capture system to collect statistics that drive productivity and cost reporting systems. Including key data such as estimated cost or relative values in the production file provides a controlled yet very accessible database and analytical tool to users of this information.
• Using the Interface Scripting Module will allow the changes made within Chargemaster Toolkit™ to be directly uploaded into your financial system. This module requires some additional data fields that are detailed in the User Guide Instructions.

Further Reading:

The Chargemaster Toolkit™ Starter Pack provides detailed information regarding required fields and PC/Network specifications. Download the pack from the following link:

Chargemaster Toolkit™ Starter Pack

The Starter Pack documents listed below provide more information on data fields.

• 2a CDM file Formats
• 2c ISM CDM Requirements.pdf
• 4 Minimum Specifications.pdf

Follow the instructions provided in these documents carefully to assist you with your CDM file generation and preparation for install.

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