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Revenue Cycle Management Healthcare: All the Stats and Facts
by Pearl Smith Writer Revenue Cycle Management Healthcare includes a couple of things relevant to the operation of a healthcare facility specifically it’s a financial cycle.Some of these things include the financial analysis of the facility, the billing software, as well as the payment record of every patient that can be accessed anytime when it’s needed. This tracks the financial activity of every patient from the start till the end and the resources and services being billed under their name to make sure that all are being settled.
In a way, Revenue Cycle Management Healthcare opens up an opportunity to bridge the gap between the clinical and financial areas of a healthcare facility. Aside from the health records of the patient provided by the physician, financial data are also being made available such as a patient’s insurance provider, coverage, and how much the treatments they availed costs.
Health care insurance is a big part of the healthcare industry and especially in the Revenue Cycle Management Healthcare. Whenever a patient sees a physician, staff from the facility checks their insurance provider and coverage so that whenever the doctor or the patient has any questions about it, they will immediately know the answer. After the patient is treated or given medications, their healthcare provider checks and categorizes it according to specific codes. The healthcare facility then sends a summary to them so that they’ll know how much of the service will be covered by the insurance company.
What is the Revenue Cycle?
The revenue cycle of a healthcare company includes all the operations and processes that have to do with recording all the billable activities of a patient. Since it’s a cycle, there’s a process involved which includes the following:
- The physician renders medical services that can be billed.
- The healthcare facility submits claims to the insurance company of the patient.
- The claims will be reviewed and will be assigned a specific predetermined code.
- The patient pays the balance and the healthcare facilities collect the payments.
- The healthcare facility gathers information from the patient and the insurance company before they arrive.
- When the patient arrives, a medical record will be created for them.
- The healthcare facility collects payments from third-party insurances.
- The necessary medical procedures will be determined.
Factors That Can Affect Revenue Cycle Management Healthcare
The healthcare facility has very little to no control over the payment from the claims they sent over to the insurance company. If it takes a long time for the claims to be paid, this may result in it being disregarded due to the unresponsiveness on the insurance provider’s side. This is the reason why an increasing effort is being made in the healthcare industry to avoid fraud.
Other factors that can greatly affect the Revenue Cycle Management Healthcare includes the number of patients, the amount of time needed for the fee collection, and others that can potentially disrupt the cycle.
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About Pearl Smith 
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20 connections, 0 recommendations, 66 honor points.Joined APSense since, August 26th, 2019, From florida, United States.
Created on Jul 9th 2020 05:50. Viewed 366 times.
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