CASE STUDY

Empowering Financial Health: e4health CDM Review Improves Financial Outcomes

Background

A prominent Mid-Atlantic healthcare system recently faced significant challenges in managing its Charge Description Master (CDM), which led to revenue leakage. With over 50,000 CDM entries to manage, the complexity of the task was overwhelming. The organization needed a partner that could not only handle the scale of the project but also deliver results quickly and efficiently.

Objective

The aim was to conduct a comprehensive CDM review and cleanup operation to reduce the missing revenue gap, enhance charge capture processes, and ensure compliance with healthcare regulations.

Actions Taken

e4health’s Charge Services Experts and CDM Consultants were deployed three months prior to the go-live date. The team undertook the following key initiatives:

  • Cleanup of over 50,000 CDMs across 15 distinct care settings, representing an estimated value of $2.1 billion.
  • Reduction of the missing revenue gap from 62.81% to 15.4% within six weeks at a flagship hospital, impacting $1.1 billion worth of charges.
  • Leadership in Chargefest testing, resulting in the creation of 20 innovative Chargefest templates.
  • Construction of more than 90,000 bill codes and prices across dual domains.
  • Update of over 300,000 bill codes and prices, amounting to more than $90 million.
  • Recovery of over $5 million in previously missed Lab send-out charges.
  • Maintenance of pricing, CPTs, and CDMs for more than 100,000 charges valued at $2.5 billion.

    Results and Insights

    The strategic partnership with e4health led to a dramatic turnaround in the healthcare system’s financial health. The missing revenue gap was significantly narrowed, and the organization witnessed a remarkable improvement in charge capture efficiency and compliance.

    How Can We Help?

    e4health’s expertise in mid-revenue cycle management and its commitment to empowering better health through innovative healthcare solutions was evident in the success of this project. For more information about e4health’s charge flow solutions and how they can transform your organization’s revenue strategy, visit e4.health.