CHARGE MASTER (CDM) MAINTENANCE SERVICES
Process
St. Clair has two options for the performance of ongoing CDM maintenance:
Option 1. Annual CDM maintenance reviews, or
Option 2. Quarterly CDM maintenance reviews.
Under both approaches, St. Clair can use the Ingenix Chargemaster Analyzer Software, whose edits incorporate the regulatory/coding updates in advance of the effective dates. For each CDM maintenance review, the Hospital receives recommended CDM code changes, with supporting documentation, in the same Excel spreadsheet format as provided by the Hospital. As a part of the ongoing maintenance service for contracted hours per month, St. Clair responds, via telephone and email, to any questions about our CDM review(s) and the CDM impacts of regulatory/coding changes. Also, we check the Hospital and/or Medicare billing system edit reports for frequently repeating coding/billing errors in order to identify any caused by CDM problems. Such error checks may include an audit of medical records for involved outpatient encounters against the UB-92s.
Pricing Approach
The St. Clair prices for the annual and quarterly CDM maintenance service are fixed.