impact story

Children’s Hospital Models True Financial Impact of Chargemaster Pricing

Inability to Analyze Impact of Pricing Within Current or Future Contracts

Because contract data and chargemaster data reside in separate systems, healthcare organizations often struggle with understanding the financial impact of their pricing. Unable to analyze changes in pricing within current or future contracts, providers miss significant revenue opportunities that contribute to improved margin.

One of the nation’s top children’s hospitals needed to better understand the impact of pricing on reimbursement, revenue, and margin. In the past, analysts would have spent weeks pulling data from thousands of accounts to make an estimate in one area. In one example, this hospital received denials for separate neuro-monitoring charges and wanted to begin bundling these charges at the OR level to avoid future denials. First, they needed to understand the impact of that decision.

This organization drove results and impact

Modeled reimbursement impact to drive down denials

Saved weeks of manual, tedious effort by transitioning to automated modeling

Armed leaders with information on impact of their decisions to reimbursement

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