How to Maintain the Epic Charge Router

The Epic Charge Router is one of the most robust pieces of charging functionality within the Epic EMR platform. It can singlehandedly create new charges, delete unnecessary charges, and update any item of the charge records it pleases. On the surface the charge router seems like a tool to solve all complex issues derived from your integrated revenue integrity team.

Last week The Wilshire Group brought you the three core guiding principles for knowing how to automate the charge router.  Two weeks ago, we brought you the three core guiding principles for when to automate the charge router. Today, we bring you the final part our three-part charge router series; maintaining the charge router.

Understanding how and when to utilize the Epic charge router is very important, but what do you do after the initial wave of build is complete? How does your staff optimally maintain the charge router to ensure issues do not arise in the future? As roles, responsibilities, and personnel change naturally within an organization, it is all too common to find build being added to the Epic charge router without any standard approach or process in place. It happens. Teams need to fix an issue or optimize a workflow, so changes are made.

Without the right process in place post-implementation, you risk overriding current router build, creating inaccurate router build, or just creating a router that is difficult to comprehend in a moment’s notice. Our team at The Wilshire Group sees these issues arise often so today we are bringing you our three guiding principles for maintaining the charge router: Create a Router Design Document, Determine Charge Router Owners, and Implement a Defined Change Control Process.

Create a Router Design Document

The first guideline for optimally maintaining the charge router is to create a charge router design document. Although it’s easy to find the charge router profile within Hyperspace, comprehending every piece of build can be cumbersome. There are multiple layers and stepping through each layer to find what you are looking is not easy, especially as the router continues to grow.

Creating a design document allows each builder to provide more information on what was built and why it was built. There are descriptions within the charge router, but this information doesn’t include the background on the build or who designed and tested the build. Additionally, it is much easier to search (Ctrl + F) through a word document to find keywords than it is the charge router.

The design of the document is flexible to what your staff feels they need, but at the very least, it should include a detailed description of the build, date created, owner, and a screenshot of the build. For safe measure, at the top of the page, we also recommend including your organization’s guiding principles for building in the router (i.e. what is your change control process and testing process as defined below).

This document should be updated after any build is added, changed, or removed. It is critical that this expectation is set. If there is not a living document outlining the router build, it will be exponentially more difficult to maintain the router.

Determine Charge Router Owners

During implementation, it can be easy to forget who “owns” specific features within the Revenue Integrity team. Typically, there are one or two billing analysts that focus on charging in conjunction with the charge master, but often there are many other hands in the charge router. This is common and to be expected during implementation, but after implementation, processes and roles need to be re-defined. Post-implementation, we highly recommend defining a true owner of the charge router (along with other pieces of build). This person(s) should have a great in-depth understanding of each piece of build and be able to provide an initial yes/no to potential router build.

It’s very important that the owner of the charge router is not the only person building in the charge router. Having one person as the sole owner/builder is not optimal when there are outages, especially if it is a critical issue.

Implement a Defined Change Control Process

Implementing a defined change control process may seem obvious and most likely is already in place to some degree at your organization. Many IT teams have a daily change control meeting to discuss changes that could impact other teams, but we like to take it one step further with the charge router. Often, you’ll have a representative from each core application in the room, but that doesn’t mean you have the right representation for the charge router.

In advance of taking your charge router build to your organizations change control process, you need to have a process in place to get your charge router build pre-approved by your Revenue Cycle team. This does not need to be a standing meeting, rather a quick discussion with the owner (s) of the charge router and other potentially impacted members. Next, follow up on these informal discussions with an email outlining your build changes, the anticipated impacts, your testing steps (both workflow and regression), and when you expect the build to move to production. Think of it as an opportunity to get all your ducks in a row before your IT team’s daily change control meeting.

The purpose of this is simple: communication and transparency. Many errors can be resolved through communication across the appropriate parties. With functionality as critical as the charge router, you should always take the opportunity to over communicate prior to completing build in Production.

The charge router cannot be neglected following implementation. Successful organizations make a commitment to maintain this powerful tool long-term. These guiding principles can be applied to all Epic customers from installation through perpetual maintenance.  If you have questions or if your team continues to struggle with their approach to implementing and building in the Epic Charge Router, our team of experts at The Wilshire Group can help you develop the necessary processes and steps to get your router in great condition.

For more information on how we can help your Revenue Integrity team, please reach out to Gretchen Case (g.case@thewilshiregroup.net), Nick Freund (n.freund@thewilshiregroup.net), and Ryan Sommers (r.sommers@thewilshiregroup.net).

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