Your Go-to Guide on Charge Automation in Epic

Maximizing revenue from the services you continue to provide during the COVID-19 response while also preparing for the uptick in volume during the recovery is critical in today’s climate. According to an MGMA survey, physician practice revenue has decreased by 55 percent on average since the beginning of the COVID-19 crisis, while patient volume has fallen by an average of 60 percent. 

Luckily, maximizing charge automation can help. Automatically dropping more charges during clinician documentation will: 

  • Help reduce missing charges 
  • Improve your time to charge 
  • Allow you to send claims more quickly and focus on improving net revenue while saving your clinicians time and effort 
  • Ensure documentation and charges match 1:1 and reduce manual charge entries, which often require correction  
  • Increase time for patient care 
  • Increase clinician satisfaction and efficiency 
  • Decrease denials for late charges 
  • Lower late charge percentage 

Based on our experience, you might find an accuracy rate of about 70% if you exclusively use charge preference lists to drop charges, versus 90% when primarily using documentation to automatically drop charges.   

Charging in a clinical setting happens one of three ways:  

  • Automatically through documentation and orders  
  • Via the charge capture preference list 
  • Via your friends in coding and revenue integrity  

Dropping charges correctly the first time avoids time wasted tracking down lost revenue and improves the accuracy of department budgets. While tackling charge automation may seem like a lofty goal, here are some focus areas to give you a head start for your discussions with IT. 

Charge and Order linking 

What is it? 

Charge linking, otherwise known as Orderable/Procedure/Chargeable (OPC) linking, is the most basic form of charge automation. It allows a linked charge to drop automatically after you place and complete an order. 

What are the best use cases? 

It’s most valuable for orders and charges that are always bundled together for certain procedures, such as Point of Care lab or imaging orders. Automatically dropping the charge after resulting or completion of the exam ensures accurate and timely charge information. 

Using charge linking for Bed Charge billing can also drop your timed or daily bed charges for inpatient units, ranging from med surg to ICU or post-op surgical recovery areas. While you likely have this built out today for existing units, it is important to review build and ensure correct documentation for additional ICU and med surg beds to meet patient surge needs during this pandemic response. 

Medication charges can also be set up to drop automatically upon administration to help ensure that charges are only dropped after medications are administered and the correct patient information is documented. 

Flowsheet Based Charges 

What is it? 

When a clinician completes documentation in a doc flowsheet row, a charge can be dropped automatically in the background or one can be recommended based on overall flowsheet charging at the point of charge capture. If clinicians document their flowsheets in a timely manner, you can ensure that charges are filed at the same time without the need for an additional step. This can reduce missed charges and time needed for reconciliation. 

What are the best use cases? 

Devices, including ventilators, can charge based on documenting in the doc flowsheet. Respiratory therapy charges can also be dropped as timed or one-time charges via flowsheet documentation as a standard part of their workflow. You can use this build to suggest additional charges to drop manually in the charge capture navigator. 

Explosion Charges 

What is it? 

Explosion charges automatically drop multiple charges after the initial one is dropped. Providers can frequently forget to file multiple charges associated with a procedure, but explosion charges can be set up so it drops all related charges when they file the charge for the procedure. This can reduce missed charges and the time needed for reconciliation. 

What are the best use cases? 

You can utilize this type of charge in a hospital’s outpatient surgical department by choosing one charge for a certain procedure and setting up the build to drop related supply, professional, and facility charges to minimize missing charges and save clinician time for charge entry. 

Procedure-based Documentation (Proc Doc) 

What is it? 

Proc Doc is used to drop charges for a procedure as clinicians are writing and filing their notes using SmartForms. Some build is required from IT to allow these charges to drop automatically, but it can be used for any Epic Foundation Released procedure note templates. 

What are the best use cases? 

These types of charges are most often used for Emergency Departments, outpatient specialties (i.e. wound), and inpatient departments. Although Proc Doc may not be appropriate for every procedure, it can save clinicians valuable time, keep documentation together, and reduce missing charges. 

Note-based Charging 

What is it? 

When providers file certain note types, a charge capture box popup appears and reminds clinicians to drop charges after filing their initial professional note for a patient. Though simple, note-based charging can be very effective at reminding providers to drop charges. 

What are the best use cases? 

When seeing patients during rounding, providers write and file their initial progress notes and are prompted with a popup to remind them to drop their charge. This saves clinicians any extra clicks and headaches when dealing with queries and missed charges. 


When implementing charge automation, it is important to make the system work for you, not the other way around. Review best practice system build recommendations for charge capture per charge type to ensure the system is automatically capturing charges, eliminating end-user intervention where possible, and giving your caregivers peace of mind. 

Questions about the charge automation process?