Healthcare Reimbursement-2

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Health Science

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Dec 6, 2023

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Michelle Crockett Southern New Hampshire University Healthcare Reimbursement Erika Albritton September 18, 2022
Milestone one Healthcare reimbursement describes the payment that the hospital, doctor, diagnostic facility, or other healthcare providers that receive for giving you a medical service. It is a higher compliance structure for receiver paid-for- services, “Revenue cycle management is the process used by healthcare systems in the United States to track revenue from patients from their initial appointment or encounter with the healthcare system to their payment of balance(2019)”. It can be difficult for healthcare to establish an excellent medical billing process with there being changes constantly and with new payment structures. If we continue to offer service and we do not collect any money or get any Reimbursement, the organization would not be able to operate for long. They rely on healthcare insurance compensation to pay for the operation of the organization. The Revenue Cycle is the sum of the billing process, reimbursements, and income creation. The cycle begins with the front- end process which begins when the patient makes their appointment. During this process you verify the patient's demographics in detail asking them to repeat their address and telephone number just to make sure it is up to date. You want to ask for the source of payment, “Revenue cycle starts with the appointment or hospital visit and ends when the provider or hospital gets paid fully for the services provided.”. You do this so they will be prepared to pay at time of visit. Last, you verify the requirements of the insurance. If they have a copay or to make sure we accept the insurance. The middle process of the cycle is where you make sure that all the clinical documentation and The ICD-10 codes are correct during the encounter with the patient. The back-end process of the The revenue cycle resides with the business office. They handle the billing process, posting payments and working on any claims that need to be corrected due to a denial with codes, appeal on claims, or just needing more
documentation from the clinical team, “The most difficult part of the revenue cycle process is patient collections. The best time to get money from a patient is when they are in your office. For that reason, it’s recommended that front desk staff are trained to collect at the time of service. To prevent the collections backlog from snowballing, make sure you have a standard policy for collecting copayments and deductibles that sets the financial expectations for the practice. (2019)”. Departmental Impact on Reimbursement management of the reimbursement process affects the profitability of an organization (Harrington,2021). The organization should use a good assessment technique to measure the effects of multiple agencies on compensation. They have seven elements to healthcare compliance, conducting internal monitoring and auditing, implementing compliance and practice standards, designating a compliance officer or contact, conducting appropriate training and education, responding appropriately to detected offenses and developing corrective action, developing open lines of communication, and enforcing disciplinary standards through well published guidelines, “Just as important is making sure routine patient statements go out. The best practice is a daily statement cycle – your patients will get one statement every 30 days, but statements go out more quickly, allowing you to get your revenue cycle moving better and your cash flow gets accelerated. Clean up your patient collections so you don’t have to bring in a bill collector. If you are having trouble with your process, consult an expert for help. If you are struggling with any part of your revenue cycle process, consult an expert to review the steps. Taking time to clean up your processes now will pay off in the long run(2019)” . It is critical to
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