Terms in this set (20)
what are the
4
phases that make up the revenue cycle? why is proper management of the revenue cycle critical to the financial performacne of healthcare providers? most healthcare providers do not get paid the entire bill at the same time services are rendered.
Are the six stages of the revenue cycle?
The Six stages of the revenue cycle are
provision of service, documentation of service, establishing charges, preparing claim/bill, submitting claim, and receiving payment
.
What are 4 steps in revenue cycle?
- Step 2: Services and Charge Capture. …
- Step 3: Claim Submission and Denial Management. …
- Step 4: Payment. …
- Step 5: Quality Reporting.
What are the 10 steps of the revenue cycle?
- Audit Claims. …
- Root cause analysis. …
- Review the claim submission process. …
- Educate the staff. …
- Resubmit claims. …
- Review, review, review – and then review again. …
- Monitor and document progress. …
- Celebrate milestones and successes.
What are the revenue cycle activities?
- Sales Order Entry. Shipping. Billing. Cash Collections.
- Shipping. Billing. Cash Collections.
- Billing. Cash Collections.
- Cash Collections.
What is meant by the revenue cycle quizlet?
Revenue Cycle.
recurring set of business activities and related information processing operations associated with providing goods and services to customers and collecting cash in payment for those sales
.
What is revenue cycle in healthcare definition?
The Healthcare Financial Management Association defines revenue cycle as “
all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue
.” Basically, then, the revenue cycle is everything that happens from the moment a patient account is created (at …
What is a hospital revenue cycle quizlet?
What is the Hospital Revenue Cycle?
A multidisciplinary approach to reducing the amount in accounts receivable by effectively managing the production and payment cycles
.
What are the six elements that should be present at a minimum in all Chargemasters?
What are the six elements that should be present, at a minimum, in all charge masters? The six elements are
charge code, item description, department number, charge (price), revenue code, and CPT/HCPCS code
.
What is an exploding charge?
Panel charge lines
, also sometimes called exploding or parent charges, require a different approach to review than standard patient charge lines. This type of charge line creates two or more individual patient charges from one CDM charge line.
What is charge explosion quizlet?
charge explosion.
a system used to better organize charge entry for selective services
. one code is used, which then explodes into the list of supply codes used for that surgery. charge code. reflected in the order entry system or the charge slips and also represented on the firm's charge master (also known as CDM).
What is Step 2 in the revenue cycle?
Revenue Cycle Phase 2:
Capturing Charges & Submitting Claims
Charge capture from EHR minimizes manual input: Charge data should be automatically pushed from your EHR to your practice management system so that claims can be prepared, even if your EHR is from a different vendor than your PM system.
What is the first step in revenue cycle?
The first and most vital step in the revenue cycle process,
preregistration
allows the medical practice to capture demographic information, insurance information and eligibility in real time through a clearing house, often while the patient is still on the phone.
What is the last step in the revenue cycle?
The last step in the revenue cycle is
cash collections
. The accounts receivable department must know when customers pay their invoices, yet segregation of duty controls dictate that the collection and recording functions be kept separate from each other.
What are the 10 steps in the revenue cycle quizlet?
- Preregister Patients. Schedule and Update Appointments. …
- Establish Financial Responsibility. Verify patients' eligibility for their health plan. …
- Check in Patients. …
- Review Coding Compliance. …
- Review Billing Compliance. …
- Check Out Patients. …
- Prepare and Transmit Claims. …
- Monitor Payer Adjudication.
What are the 5 steps to the medical claim process?
These steps include: Registration, establishment of financial responsibility for the visit, patient check-in and check-out, checking for coding and billing compliance, preparing and transmitting claims, monitoring payer adjudication, generating patient statements or bills, and assigning patient payments and arranging …
What is a revenue cycle flowchart?
A revenue cycle management flowchart is
a useful tool to help you manage your business
. By creating a flowchart, you can see how your business is developing and where money is going. This will help you to make better decisions about where to allocate resources and budget.
What are the third basic activities in the revenue cycle?
The third basic activity in the revenue cycle involves:
Billing customers
.
Updating accounts receivable
.
What is revenue cycle accounting?
Revenue cycle is
a method of defining and maintaining the processes used for completion of an accounting process for recording of revenue generated from services or products provided by the company
which include the accounting process of tracking and recording transaction from beginning, normally which starts from …
What step is used when patient payments are later than permitted under the financial policy?
What step is used when patient payments are later than permitted under the financial policy? Step 10,
follow up patient payments and collections
.
When a POS operation is elected under a health maintenance organization the patient may?
When a POS option is elected under a health maintenance organization, the patient may? A
pay an additional cost
.
Premium. The premium is
the amount paid to an insurance agency for a health insurance policy
. The premium is often paid on a monthly basis.
What is revenue cycle pro?
RevenueCyclePro.com is an up-to-date, online coding referential tool hospitals can use to access data and medical code sets; answer questions about coding, billing, coverage, and reimbursement; and resolve edits, problems and issues to minimize non-compliance exposure.
What stage kicks off the patient care and revenue cycle?
Patient Pre-registration
The first step is always crucial as it starts even before a patient get enrolled in the system. Patient's data include Name, medical history, payer details, and payment mode are collected.
