The definition of the revenue cycle encompasses “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” In optimizing your revenue cycle, three major end-to-end areas are critical: front-end, middle, and back-end processes.
As we begin the reemergence of services, there are several operational considerations and opportunities to explore. The landscape of healthcare has changed with COVID-19 and will have an immediate and long-term impact on reimbursement for professional services. The goal is for this framework to assist with continuing to break down the silos of critical revenue cycle areas, identify "new" opportunities for reimbursement and ultimately assist with the reemergence of your programs.
Presented by: Nicole F. Knight, LPN, CPC, CCS-P
This graphic illustrates the critical areas of the revenue cycle.
Managing your revenue cycle response during COVID-19 is necessary in painting the picture for financial projections. We are working with many solutions in our new world that impact the people, processes, technology and ultimately reimbursement of services. Focusing on the immediate needs of our programs and planning for reemergence present another layer of potential potholes. Having a coordinated plan that continues to manage changes, measures performance and sets goals is critical. Below are some potential pitfalls and pearls to consider through the journey.
This presentation is for general information purposes only and is not intended and does not constitute legal, reimbursement, coding, business or other advice. Furthermore, it is not intended to increase or maximize payment by any payer. Nothing in this presentation should be construed as a guarantee by MedAxiom regarding levels of reimbursement, payment or charge, or that reimbursement or other payment will be received. Similarly, nothing in this presentation should be viewed as instructions for selecting any particular code. The ultimate responsibility for coding and obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all coding and claims submitted to third party payers. Also note that the information presented herein represents only one of many potential scenarios, based on the assumptions, variables and data presented. In addition, the customer should note that laws, regulations, coverage and coding policies are complex and updated frequently. Therefore, the customer should check with their local carriers or intermediaries often and should consult with legal counsel or a financial, coding or reimbursement specialist for any coding, reimbursement or billing questions or related issues. This information is for reference purposes only. It is not provided or authorized for marketing use.
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