Chargemaster Management Solutions
Location:
New York, United States
Posted on:
Deadline:
Summary:
RFP seeking a chargemaster management solution that includes auditing, regulatory reference, medication analytics, and a customizable user interface, with real-time validation and policy access.
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The organization is seeking vendors to provide a comprehensive chargemaster management solution. The auditing software should analyze extracts of the live Chargemaster (CDM), identify potential discrepancies, and recommend corrective actions. The system must ensure that all rendered services are accurately documented and billed, thereby minimizing revenue leakage.
Additionally, the regulatory reference component should offer immediate and integrated access to extensive clinical, coding, financial, and regulatory data. The solution must include medication analytics capabilities to evaluate purchase, billing, and remittance data, giving pharmacy leaders key insights at the medication level for better-informed business decisions.
The system should supply instant access to up-to-date regulatory references and perform real-time analysis and validation of modifications or potential coding issues. A customizable, user-friendly interface should support requests to add, modify, or deactivate charge items. Furthermore, the solution should provide real-time access to medical necessity and prior authorization policies for Medicare, Medicare Supplements, and commercial payors.
Best-fit vendors:
• Proven experience in implementing chargemaster management systems for healthcare organizations
• Expertise in healthcare billing, coding, and regulatory compliance
• Ability to integrate auditing, analytics, and reference solutions
• Track record of serving clients in New York or the Northeastern US
• Strong background in clinical and financial data management
