Rational
- Recognizes third party reimbursement levels
- Recognizes the RCC
- Makes sense of charges
- Restores relationship between charges and allowances
Our Process
A rational charge master produces rational pricing that recognizes third-party reimbursement levels and the cost-to-charge relationship where charges are impacted by intensity and acuity.
Too many charge masters are out-of-whack as a result of the cumulative impact of across-the-board percentage increases to offset an increase in costs or years of increasing charges wholly based on market pricing.
The result is an inefficient and ineffective charge master that obscures the real cost of services, making pricing much less transparent and defensible.
We fix this by completing a thorough analysis of historical charge data, and focusing on third-party reimbursement levels and the cost-to-charge relationship. Also, we review payer contracts and payer history to create a payer scorecard for all services.
We base charges on cost plus a consistent mark-up to deliver
Deliverables
Cost accounting is relevant once again as providers streamline services, innovate, and compete. Rational pricing assumes a more favorable ratio-of-cost-to-charges (the RCC) as part of an enhanced market pricing strategy.
Our deep-dive data drill-downs produce actionable intelligence that helps you improve the RCC and position the hospital as-desired in your market.
1. Makes sense of charges and tightens the RCC
2. Creates strategic market pricing that differentiates your hospital from the competition
3. Facilitates a drill-down to the real cost of services on multiple levels
4. Helps identify the most profitable service lines and those meeting changing demographic needs