Charge Capture
Charge capture is the process of documenting all billable services and supplies provided during a patient encounter into the billing system, ensuring that every service rendered is coded and submitted to the appropriate payer for reimbursement.
What is Charge Capture?
Charge capture encompasses every step between a service being rendered and the corresponding charge appearing in the billing system: service documentation, code assignment, charge entry, and routing to the appropriate revenue cycle workflow. Charge capture failures take three forms: services rendered but never coded (lost revenue — estimated to affect 5–10% of potential hospital charges), services coded at a lower level than the documentation supports (under-coding, common in E/M services where clinicians default to lower-complexity codes), and duplicate charges (compliance risk). The Charge Description Master (CDM) is the hospital pricing database that links each service to a revenue code, CPT/HCPCS code, and charge amount — CDM maintenance is a regulatory and operational requirement. Charge lag — the time elapsed between service delivery and charge posting — should be below 24 hours for professional billing and below 48 hours for facility billing; longer lag times compress accounts receivable and create reconciliation complexity. Charge capture analytics compare actual charges per encounter type against expected charges and identify providers with outlier low coding intensity.
Why It Matters for Healthcare Analytics
An estimated 5–10% revenue loss from charge capture failures means a $10M practice could be losing $500,000–$1M annually in services delivered but never billed. Identifying which service lines, providers, or encounter types have the highest charge lag and the greatest gap between expected and actual charges is the first step to recovering lost revenue without adding clinical volume.
How Vizier Tracks Charge Capture
Upload your billing data and ask "Which providers have a charge lag over 48 hours or an average E/M coding level below department median?" — Vizier surfaces outlier charge patterns, calculates expected vs. actual charges by encounter type, and quantifies the revenue gap attributable to under-capture.