New Nursing Charge Automation Adds $45K in Weekly Revenue

Every missed charge is a missed opportunity, and hospital sustainability depends on operational efficiency and revenue integrity. One acute care hospital recently partnered with CereCore because they suspected revenue leaks stemming from their EHR, MEDITECH Expanse. Our team assessed the hospital’s revenue cycle and end-to-end financial impacts within the EHR. The solution? Automating nursing charges to post directly from clinical documentation within their MEDITECH EHR. The innovative, streamlined workflow resulted in $45,630.75 in additional revenue in just one week without adding work for staff.

The Challenge: Missed Charges and Manual Processes 

Historically, nursing-related procedures were inconsistently captured for billing purposes. This was due to a reliance on manual charge entry processes and a disconnect between clinical documentation and financial systems. As a result, many high-value services went unbilled, leading to significant revenue leakage. 

The Solution: MEDITECH Optimization with Automated Charge Capture  

CereCore implemented a targeted strategy to automatically generate nursing charges based on clinical documentation triggers within the MEDITECH EHR. By mapping specific procedures and interventions directly to nursing documentation entries, system configurations ensure applicable charges generate in real time—eliminating the need for manual entry from nursing staff or coders. 

Example Charges Captured Automatically 

Revenue Cycle Automation Adds Up 

Let’s consider the average patient volume of this 61-bed facility and assume automated nursing charge capture totals remain consistent. 

$45,000 x 4 weeks/month = $180,000 estimated monthly revenue recovery

$180,000 x 12 months/year = $2.1M in estimated total annual revenue recovery 

This is just one example of charge capture automation. Imagine this result in a different size facility, and you can see how this strategy adds hidden revenue streams.  

Consider the opportunities:

• What strategic initiatives could you fund with an additional $2M annually? 
• How could reinvesting $2M annually transform patient outcomes or reduce disparities in your community? 
• What other areas of operations could benefit from automation if this one yields $2M? 
• How much revenue are you potentially leaving on the table in other departments?  

Key Outcomes 

• Increased Revenue: Over $45K in one week through accurate and timely billing. 
• Reduced Nurse Burden: No additional documentation tasks for staff. 
• Improved Compliance: Charges aligned directly with documented care, enhancing audit readiness. 
• Scalable Model: The automation framework can be extended to additional procedures and departments. 

Why It Matters 

This implementation is a clear demonstration of how thoughtful alignment between clinical workflows and financial systems can yield immediate results. By leveraging the flexibility of MEDITECH and the expertise of CereCore’s consultants, hospitals can recover lost revenue, reduce administrative overhead, and ensure the full scope of care is captured for reimbursement. 

What Else Should You Know? 

How long did the implementation take to complete? 

From beginning to end, the assessment and solution implementation took three months, working closely with revenue cycle and clinical leaders.  

Was this a quick win or a multi-month project? 

This was one of several quick wins identified during the MEDITECH assessment and optimization project.  

Additional focus areas included:

• optimizing materials management 
• streamlining laboratory billing 
• aligning community-wide appointment scheduling with order mapping 
• implementing best practices in the HIM department 
• enhancing surgery billing and documentation 
• improving nursing care planning and documentation 
• refining physical therapy workflows and billing processes and more. 

Can automated billing be configured for other departments? 

We are actively enhancing revenue generation by automating charge documentation across multiple departments, including dietary, physical therapy, surgery, and DEM/orthotic devices. 

We have previously collaborated with other healthcare organizations to automate ED care level acuity billing, and we're currently implementing automated ED billing at this hospital. Read how automated ED billing works.

This automation can be integrated during a new MEDITECH Expanse implementation or as an optimization project within an existing system.  

Is there a roadmap for expanding this automation? 

Yes, here’s a process you can use in your organization to get started: 

1. Conducting an assessment. Begin by evaluating current charge capture and billing workflows. Identify pain points, inefficiencies, and areas where automation could improve revenue generation.
2. Identifying gaps. Analyze existing processes to pinpoint missing or incomplete charge capture opportunities. Compare workflows against best practices and industry standards to determine areas for improvement.
3. Mapping out missed charges. Work closely with department leads to track missed or unbilled services. Create a detailed map of potential revenue leakage and opportunities for automation.
4. Collaborating with revenue departments. Engage revenue cycle management teams to review billing codes. Ensure that each service provided has a corresponding charge code that aligns with payer requirements.
5. Inputting billing codes into design documentation. Integrate billing codes into system design documentation, ensuring accuracy in automated charge generation. Define rules and triggers for charge capture within MEDITECH Expanse or other EHR systems.
6. Working with clinical leadership. Partner with clinical leadership to validate and refine automation workflows. Align automation efforts with operational goals to ensure compliance, efficiency, and accuracy.
7. Implementation and optimization. Deploy charge automation as part of a new system implementation or an enhancement to an existing setup. Monitor performance, refine workflows, and provide training to staff to ensure seamless adoption

How were staff trained or onboarded? 

The automated charge documentation system is designed to integrate seamlessly into nursing workflows, requiring minimal training as it aligns with existing documentation practices. Within best practice guidelines, department leadership should be trained on billing reports to ensure accurate charge capture, especially if they haven’t already adopted this standard practice. This approach enhances efficiency while maintaining compliance and operational consistency. 

Final Thoughts 

EHR optimization, like automated charge capture, yields high returns. As this acute care hospital discovered, integrating technology with workflow optimization isn't just a technical upgrade—it's a revenue strategy. 

Next Steps 

Interested in learning how CereCore can optimize your hospital’s EHR performance and financial outcomes? Let’s talk.

Explore more resources:

• How to Transform Patient Scheduling: 7 MEDITECH 2.2 Features
• Maximize the Value of your EHR
• Elevate Your Revenue Cycle Performance: MEDITECH Revenue Cycle Assessment and Optimization