Charge capture
The process of identifying, recording, and transmitting all billable services delivered during a patient encounter so they can be translated into a claim. Charge capture is the bridge between clinical delivery and billing. If a service is performed but not captured, it is never billed and the revenue is permanently lost.
Why this matters for your clinic
Missed charges are invisible. They do not show up as denials or write-offs. The revenue simply never enters your billing system. Most practices have no way to measure charge capture failure because you can only count claims that were actually submitted. Estimating capture failure requires comparing expected charges per encounter type against actual submitted charges.
Charge capture problems are most common in high-volume, multi-provider environments where providers document in the EHR but billing codes are not reliably mapped or triggered. Hospital-owned clinics historically had charge capture failure rates of 3-7% of gross charges before EHR integration improved, but the same risks exist in any practice without a systematic capture workflow.
Ancillary services are where charge capture most often breaks down in outpatient clinics. Injections administered during a visit, supplies used, diagnostic tests ordered and completed in-office — these are frequently documented clinically but never transferred to the billing queue. A periodic charge audit comparing clinical documentation to submitted claims is the only way to find these gaps.
What good looks like
Charge capture benchmarks are not widely published because practices rarely measure failure rate directly. HFMA and MGMA advisory guidance recommends quarterly charge audits comparing documented services to submitted claims by service category. Any systematic gap above 1-2% of gross charges warrants a workflow fix rather than just staff retraining.
Example
An urgent care clinic performs 40 rapid strep tests per day. Each test has a billable CPT code worth roughly $25-30 in net reimbursement. If the lab interface is not correctly mapped to the billing system and tests are documented in the EHR but not auto-populated into the claim, the practice loses $1,000-$1,200 per day in missed charges. Over a year that is $250,000-$300,000 in revenue that was earned and delivered but never billed.
From Sorso
In almost every revenue cycle audit we do on a new client, we find at least one ancillary service category where charges are being routinely missed. It is rarely the high-value procedures. It is almost always a systematic EHR-to-billing mapping gap on something modest but high-frequency.
Founder of Sorso. 19 years in corporate finance. Managed a $450M loan portfolio before building a fractional CFO firm exclusively for healthcare clinics.
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