Revenue Cycle Management is the process of managing your claims processing, payment and revenue generation. This includes everything from determining the patient’s eligibility, collecting their co-pay, coding the claims, tracking the claims, collecting payments and following up on denied claims. A critical part of your office function, it is important that the entire revenue cycle process is managed efficiently.
John is definite that he wants a career in the healthcare industry. After all, the healthcare industry is one of the fastest growing sectors in the country and John is sure that there were many opportunities for those willing to work diligently. When he expressed his desire of joining the healthcare industry to his immediate neighbor and good friend,
Robert was shocked, as he read the news regarding the settlements made by the hospitals, for incorrect Kyphoplasty procedures. He clearly remembered that day, when his mom had to undergo the same procedure, way back in 2006. Although active and otherwise healthy, his mom suffered from osteoporosis since the last three years. Last week, she slipped in the kitchen and felt a sharp pain in her lower back.
As we come to the end of another year, it is good to look back and reflect on the highlights of the year – the good, bad and the ugly. Understanding what could have been avoided; done in a better way and what was just perfect, is a great way to build on your new year resolutions.
The adoption and use of new technology is driving several new trends in the healthcare industry. As the industry moves towards becoming more patient centric, interoperability and security measures are bound to progress at a steady pace. One of the fastest moving trends, electronic health information exchange (HIE) will see an increased adoption by all providers along with a much greater interoperability between Federal and State agencies on one hand,
If you look at your patient’s problem holistically, why would you not do so with your revenue cycle problems too? Similar to the human body, where different organs work in tandem to keep the body healthy; in revenue cycle management different parties come together to keep the cycle healthy. These would include the patient,
Revenue cycle is defined by the Healthcare Financial Management Association as “All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” The term includes the entire tenure of a patient account – from its creation to the payment. The process of revenue cycle flows into and affects each component of the system.
Often mistakenly assumed to be the same, medical billing and medical coding are two very distinctly separate jobs. Although there are many similarities between the two and small healthcare settings may entrust a single person for doing both the tasks; most medium and large healthcare facilities have different individuals responsible for the two different jobs.
When Dr. Robert Schultz started his presentation to the Board of Directors of the hospital, he was not too confident on the outcome. After all, as his Chief Financial Officer had pointed out, it was not easy to convince the Board to allow an increase of nearly 10 percent in their capital expenditure budget. While it was true that the hospital was making large strides in population health management,
Population health management (PHM) is moving forward at a very rapid pace, due to the shift in healthcare priorities and related business models coupled with the ever increasing cost of healthcare and helped by the emergence and utilization of big data analytics.
Before we get to the issue of how population health management works,