What Was Actually Provided?
Identify the billable services, procedures, supplies, or other applicable charges documented for the encounter.
CHARGE ENTRY SERVICES
Charge Entry Services That Help Turn Documented Care Into Clean, Billable Charge Data.
Charge entry is the point where information about a completed encounter becomes structured billing data. A missed charge, incorrect unit, wrong provider, missing modifier, or mismatched detail can create work further down the revenue cycle.
Medical Billing and Coders provides charge entry services focused on accurate charge capture, CPT and HCPCS entry, diagnosis linkage, modifier and unit review, provider and place-of-service details, charge reconciliation, and pre-submission validation.
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Charge Capture
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Data Validation
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Pre-Bill Review
CHARGE ENTRY WORKFLOW
From Encounter to Claim-Ready Data
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01
Capture
Identify the services documented for the encounter.
02
Enter
Post the applicable charges and billing details.
03
Validate
Review codes, units, modifiers, provider and POS details.
04
Reconcile
Compare posted charges with documented encounters.
05
Release
Move complete charge data into the billing workflow.
UNDERSTANDING CHARGE ENTRY
Charge Entry Is the Bridge Between Documented Services and the Billing System.
After a patient encounter, the services performed need to be represented in the practice's billing workflow. Charge entry is the work of taking that information and entering the applicable charge details into the system used to prepare the claim.
That sounds simple, but the charge record usually has to agree with several pieces of information at once. The service, code, units, provider, date of service, place of service, diagnosis linkage, and charge amount all have to make sense together.
How Should That Information Enter the System?
Enter the charge information with the appropriate billing details, including code, units, provider, date, place of service, and other required information.
Does the Charge Data Make Sense Together?
Review the charge against available documentation and applicable billing or coding checks before it moves forward.
Did Every Encounter Result in the Expected Charge?
Compare encounters with posted charges to identify missing, dropped, incomplete, or otherwise unresolved charge activity.
OUR CHARGE ENTRY SERVICES
Charge Entry Services That Cover More Than Typing a Charge Into a System.
Good charge entry combines data entry with a structured review of the information surrounding the charge. The exact workflow can vary by practice, specialty, EHR, practice management system, and payer.
Charge Capture
Capture documented billable services, procedures, supplies, and applicable encounter charges so they can enter the billing workflow.
CPT & HCPCS Charge Entry
Enter applicable procedure and service codes with attention to the information supporting the charge.
Diagnosis Linkage
Connect charge information with the diagnosis information used within the claim workflow where applicable.
Modifier & Unit Review
Review applicable modifiers and units of service as part of charge-level validation before claim preparation.
Provider & POS Validation
Check available provider, referring provider, and place-of-service information associated with the charge.
Fee Schedule Alignment
Enter or validate charge amounts according to the fee schedule and billing setup used by the practice.
Charge Reconciliation
Compare documented encounters with posted charges to help identify missing, dropped, or incomplete charge activity.
Pre-Bill Charge Validation
Review relevant charge details before they move into claim preparation so issues can be identified earlier in the workflow.
CHARGE-LEVEL VALIDATION
A Charge Is Ready to Move Forward When the Details Agree With Each Other.
Charge-level review looks at the relationship between the encounter, documentation, codes, providers, units, place of service, and other billing details. The exact checks depend on the practice and billing workflow.
CHECK
WHY IT MATTERS
Date of Service
Keeps the charge connected to the correct encounter and service date.
Place of Service
Identifies the setting associated with the service being billed.
Billing / Rendering Provider
Helps ensure the charge carries the appropriate provider information.
CPT / HCPCS
Represents the applicable procedure, service, supply, or other billable item.
ICD-10-CM Linkage
Connects the charge with the diagnosis information used within the claim workflow where applicable.
Modifiers
Provides additional context when an applicable modifier is supported and needed for the reported service.
Units of Service
Helps ensure the quantity reported for a service is consistent with the documented encounter and applicable billing rules.
Charge Amount
Keeps the entered charge aligned with the practice's billing and fee-schedule setup.
CHARGE RECONCILIATION
The Charge That Was Never Entered Is Harder to Find Than the Charge That Was Denied.
A denial creates a visible billing event. A missing charge can be much quieter. If an encounter does not result in the expected charge activity, the problem may never reach a denial queue.
Charge reconciliation compares available encounter information with posted charges to help identify gaps that deserve review.
01
Completed Encounter, No Charge
Identify encounters where expected charge activity does not appear in the billing workflow.
02
Partial Charge Capture
Review situations where documented services may not be fully represented in the posted charge data.
03
Dropped or Unresolved Charges
Identify charge activity that may have failed to move correctly through the workflow.
04
Charge Lag
Monitor the time between the date of service and the point when applicable charges are entered or posted.
05
Repeated Entry Corrections
Recurring charge-level corrections can point to a workflow issue worth examining more closely.
PRE-BILL VALIDATION
Catch Charge-Level Problems While They Are Still Close to the Source.
The earlier a billing issue is found, the easier it can be to understand where it entered the workflow. Charge-level validation can review completeness and relevant coding or billing relationships before claim submission.
Missing Data
Identify incomplete patient, provider, service, or charge information that may need attention before claim preparation.
Code Relationships
Review applicable CPT, HCPCS, diagnosis, and modifier relationships within the charge workflow.
Units Review
Check whether units entered for applicable services are consistent with the encounter and relevant billing rules.
Applicable NCCI Checks
Where applicable, review relevant NCCI-related coding edits or unit concerns as part of the pre-bill process.
Payer-Specific Requirements
Consider known payer or practice-specific billing requirements relevant to the charge workflow.
Claim Readiness
The goal is to move complete, reviewed charge information into the next step rather than discovering basic issues after submission.
CODING + CHARGE ENTRY + BILLING
Charge Entry Works Best When It Does Not Operate in Isolation.
Coding determines how documented services are represented. Charge entry turns that information into the charge data used in the billing workflow. Medical billing then carries the claim through submission, payer response, payment, denial, and follow-up.
SPECIALTY-SPECIFIC WORKFLOWS
The Charge Entry Workflow Should Match the Services Being Billed.
Charge capture does not look exactly the same across every practice. A procedure-heavy specialty, an office-based practice, and a multi-location organization may have very different charge workflows.
CHARGE ENTRY WITH CONTEXT
The encounter, service, and billing environment all matter.
A specialty-aware workflow considers the types of services being documented, the coding structure, units, modifiers, locations, providers, and billing requirements relevant to that practice.
Primary Care
Office visits, E/M services & routine charge workflows
Cardiology
Procedure, diagnostic & service-line charge entry
Orthopedics
Procedure, units & modifier-sensitive workflows
Dermatology
Procedure and encounter-specific charge capture
Behavioral Health
Visit-based and service-specific charge workflows
Women's Health
Encounter and procedure charge workflows
Radiology
Diagnostic service and procedure charge capture
Multi-Specialty Practices
Multiple providers, locations and billing workflows
CHARGE ENTRY VISIBILITY
Good Charge Entry Reporting Helps Explain Where the Workflow Is Slowing Down.
Charge entry is not only about the number of charges posted. Practices can also benefit from understanding missing charges, charge lag, corrections, reconciliation findings, and recurring charge-level issues.
01
Charge Volume
Understand the volume of charge activity being processed.
02
Charge Lag
Monitor the time between the encounter and charge posting.
03
Missing Charges
Identify encounters or services where expected charges may not have been posted.
04
Correction Patterns
Review recurring charge-entry errors and correction categories.
05
Reconciliation Findings
Track differences identified when encounters are compared with posted charge activity.
06
Workflow Trends
Use recurring findings to identify areas where process review may be useful.
CHARGE ENTRY FAQ
Common Questions About Charge Entry Services.
Practical answers about charge capture, charge posting, coding information, reconciliation, validation, and the billing workflow.
Charge entry services involve capturing and entering the applicable billing information from a healthcare encounter into the practice's billing or practice management system. Depending on the workflow, this may include CPT or HCPCS, diagnosis information, units, modifiers, provider information, place of service, date of service, and charge amounts.
Charge capture is the process of identifying the billable services associated with an encounter. Charge entry is the process of entering the applicable charge information into the billing system. In practice, the two activities are closely connected.
Depending on the practice and service, charge entry may include patient and encounter information, date of service, place of service, provider information, CPT or HCPCS codes, diagnosis information, modifiers, units, and applicable charge amounts.
Modifiers and units provide additional information about how a service was performed or how many units were reported. Their appropriate use depends on the documentation, coding guidance, payer requirements, and the specific service being billed.
Charge entry workflows can include CPT and HCPCS procedure or service information and may also incorporate ICD-10-CM diagnosis information used for claim preparation. The exact division between coding and charge entry depends on the practice's workflow.
Charge reconciliation compares available encounter information with posted charges to identify missing, dropped, partial, or otherwise unresolved charge activity that may require review.
Charge-level problems can contribute to claim issues depending on what is incorrect or missing. Examples can include incorrect codes, units, modifiers, provider information, place of service, charge amounts, or incomplete claim data. Reviewing these details before submission can help identify issues earlier.
Medical coding interprets the documented encounter and assigns applicable codes. Charge entry brings the relevant coding and billing information into the system, while medical billing uses that information as part of claim preparation and submission. The functions are separate but closely connected.
Charge reconciliation can help identify encounters or documented services that do not appear to have corresponding posted charge activity. These findings can then be reviewed according to the practice's workflow.
CHARGE ENTRY SERVICES
Build a Charge Entry Workflow That Keeps the Next Step Clear.
Whether your practice needs ongoing charge entry, charge capture reconciliation, pre-bill validation, or support connecting charge entry with coding and medical billing, the starting point is understanding how your current workflow handles completed encounters.
CHARGE ENTRY WORKFLOW
Charge Capture
CPT & HCPCS
Diagnosis Linkage
Modifier & Unit Review
Charge Reconciliation
Pre-Bill Validation