charge master specialist Interview Questions and Answers

1. What is a charge master?

   • Answer: A charge master is a comprehensive database containing a complete list of every item a healthcare facility bills for, including services, procedures, supplies, and medications. It details the codes, descriptions, and prices for each item, ensuring accurate billing and reimbursement.

2. Explain the importance of charge master maintenance.

   • Answer: Accurate charge master maintenance is crucial for proper revenue cycle management. It ensures accurate billing, prevents denials and underpayments from insurance companies, and maintains compliance with regulatory requirements. Outdated or inaccurate information can lead to significant financial losses.

3. Describe your experience with charge master updates.

   • Answer: [Candidate should detail their experience, including the frequency of updates, methods used, software employed, and the types of changes implemented. Example: "In my previous role, we updated the charge master bi-monthly. We used [Software Name] and followed a rigorous change control process. Updates included adding new CPT codes, revising pricing based on contract negotiations, and correcting coding inaccuracies."]

4. How do you ensure charge master accuracy?

   • Answer: Accuracy is maintained through regular audits, comparisons with industry benchmarks, verification against payer contracts, and close collaboration with billing, coding, and clinical staff. Utilizing data analytics to identify discrepancies and trends is also vital.

5. What are some common charge master errors and how do you prevent them?

   • Answer: Common errors include incorrect CPT/HCPCS codes, missing or inaccurate descriptions, pricing discrepancies, and outdated information. Prevention involves rigorous review processes, automated checks, regular audits, training for staff involved in charge capture, and utilizing charge master management software with validation rules.

6. How do you handle charge master changes related to new medical technology or procedures?

   • Answer: New technologies and procedures necessitate timely updates to the charge master. This involves collaborating with clinical staff to obtain accurate descriptions, codes (CPT, HCPCS, ICD), and pricing information. A thorough review process ensures compliance and accuracy before implementation.

7. What is your experience with charge description master (CDM) software?

   • Answer: [Candidate should specify the software they've used, highlighting their proficiency in data entry, data validation, reporting, and system maintenance. Example: "I have extensive experience with Epic's CDM system, including data import/export, report generation, and user training."]

8. How do you collaborate with other departments to maintain charge master accuracy?

   • Answer: Effective collaboration is crucial. I work closely with billing, coding, clinical documentation improvement (CDI) specialists, and IT to ensure data accuracy, address inconsistencies, and resolve issues promptly. Regular meetings and communication are essential.

9. Explain your understanding of compliance regulations related to charge master management.

   • Answer: I understand the importance of compliance with regulations such as HIPAA, the False Claims Act, and state-specific requirements. Accurate charge master maintenance is vital for avoiding penalties and maintaining a strong compliance program. This includes proper documentation and audit trails for all changes.

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