Key Steps Involved in Revenue Cycle Management
healthcaretechoutlook

Key Steps Involved in Revenue Cycle Management

Healthcare Tech Outlook | Monday, August 29, 2022

It is crucial that revenue cycle management activities are effective if a healthcare provider hopes to succeed over the long haul. By doing this, they will be better off financially and be able to provide patients with the treatment they need.

Fremont, CA: Healthcare professionals execute millions of daily operations on patients, ranging from straightforward checkups to intricate surgery. Health systems must collaborate with patients, physicians, and health insurance providers to collect payment for these services. Revenue Cycle Management is the term for this revenue collection process for healthcare businesses.

It is crucial that revenue cycle management activities are effective if a healthcare provider hopes to succeed over the long haul. By doing this, they will be better off financially and be able to provide patients with the treatment they need.

So what precisely is revenue cycle management? The Revenue Cycle Management Process is shown step-by-step below:

Patient Scheduling

In an ideal world, the patient would arrange their "patient visit" in advance to start the revenue cycle management process. But unfortunately, the setting of an urgent care facility or hospital emergency room can be an exception to this rule.

Benefit and Authorization Verification

The patient's insurance information is gathered at the time of scheduling so the clinician may look up benefits and ascertain insurance coverage. This will enable the appropriate patient payments to be collected at the time of service and, if necessary, a financial planning engagement to get set up in advance of the delivery of medical services.

Medical Transcription

The clinician dictates notes that get transmitted to a third party, who then transcribes them into a medical record that may be uploaded or saved to the patient's chart rather than directly entering information in the patient's chart.

Medical Coding

Coding entails evaluating the patient encounter record and converting it into procedure and diagnosis codes. A medical practitioner can provide services denoted by procedure codes (CPT), 5-digit medical codes. The disease classifications known as diagnosis codes (ICD10) list the ailments or illnesses that led the patient to seek therapy. Many medical facilities will hand off this task to contracted medical coders.

Cash Posting/Payment Posting

Payment Posting is a step in the medical billing process that involves documenting communication of insurance choices made in relation to the claim line by line. The patient will receive these amounts if there is a patient share of costs after the payment has been deposited so that patient statements may be sent out to collect this money.

Patient Billing

An expert in medical billing may evaluate the grounds for non-payment, undertake the necessary actions to appeal, and have the claim properly reprocessed if the claim adjudication ends in denial. If this happens, the rejection gets displayed on the claim. The patient will be asked to pay the remaining sum if this results from uninsured care. Processing of Patient Bills or Statements is another name for this.

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