Hospital Revenue Cycle Analysis

You have been asked by a health care magazine to write a series of articles focusing on health care financial concepts. The articles will be included in five consecutive issues and will be geared towards readers with little knowledge of finance. You must ensure that the articles are both informative and engaging to your audience. You must also ensure that your articles relate financial principles to the health care industry.

Cherry, B., & Jacob, S.(1997). Chapter 7 Paying for Health Care in America: Rising Costs and

H. (04/2015). Comprehensive Health Insurance: Billing, Coding & Reimbursement, VitalSource for Allen School of Health Sciences, 1st Edition. [Bookshelf Online]. Retrieved from https://online.vitalsource.com/#/books/9781323131503/

The patient is informed about their coverage and the amount of copayment they would have to pay.

Step 3 - Financial Responsibility - Once we have established the patients co-pay or deductible we then let them know of the charges.

Accelerating cash collections at the point of service has never been more critical than it is today. Sophisticated accounting tools that enable providers to analyze patient utilization and outcomes help practice managers monitor payer performance and evaluate external contracts effectively. Growing financial pressure to strive toward more efficient claims flow through the revenue cycle means every provider must search for innovative tools to overcome the challenges.

There are many factors that have influenced the changes of health care economics. Money and technology has definitely been the reason for the change of health care economics over the years. Money is want makes the economy evolve. There will be advancement in technology and there needs to be people are managing these to keep up with the changes. The U.S. has definitely progressed as far as influencing factors to change in new advancement of technology and medical care. Having a good financial manager in your organization will prepare for these upcoming advancements and changes. Money drives these advancements in

The hospitals inpatient visits vary from the routine to the most complicated IPPS, and it analyzes the historical costs of providing inpatient services for a diagnosis. Additionally, it sets the payment amount to treat the diagnosis in patients at different profiles like age, sex or complications. For instance, in 1983, Medicare applied historical information to introduce inpatient prospective payment systems with a basis on DRGs (Reimbursement Methodologies, 2016). When an inpatient facility submits a claim to a third-party payer under PPS, the application enters a diagnosis related group which determines the amount receivable by a hospital. Also, hospitals submit healthcare bills for each Medicare patient to Medicare Administrative Contractors (MAC), a private insurance company working in collaboration with Medicare to offer the programs’ operational functions. Therefore, MAC administers the funds while replacing previous fiscal intermediaries and Medicare

slides. If you adopt this text you will be given access to complete materials. To obtain

Revenue cycle management (RCM) has become increasingly complex thanks in large part to the almost-constant health care reforms and initiatives. As ICD-10 is about to become the new coding standard, hospitals and private practices have begun arming themselves with as many tools and techniques as they can that will help them better manage their revenue cycles.

The major difference between healthcare finance terminology and business finance terminology is that these terms focus on factors unique to the health services industry. For example, the provision of health services is dominated by not-for-profit or¬ganizations (such as ours), which are inherently different from investor-owned businesses. Also, the majority of payments made to health¬care providers for services are not made by patients—the consumers of the services—but rather by some third-party payer (e.g., a commercial insurance company or a government program). Even the purchase of health insurance is dominated by employers rather than by the individuals who receive the services. These terms emphasize ways in which the unique features of the health services industry affect financial decisions. The healthcare industry is a service industry. It is not in the business of manufacturing, say, widgets. Instead its essential business is the delivery of healthcare services. It may have inventories of medical supplies and drugs, but those inventories are necessary to service delivery, not to manufacturing functions. Because the business of healthcare is a service, this overview of key healthcare terminology will focus on the practice of financial management in the services industry.

Internal audit will discover flaws in Bryant’s Hospital revenue cycle process. One problem, is the untimely of processing claims for patients and third party billers. This issue will not only delay payment which the hospital needs, but it will increase their Account receivable account, due to aged accounts.

Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread

The fourth step is the charge entry, this is where the bill is created. An account is set up for every patient with the demographics and the account is assigned a number. While talking to B. Mcleod (personal communication, May 26, 2015) it was also stated that one of the key functions for charge

Gapenski, L. (2006). Healthcare Finance (4th Ed.). Retrieved from The University of Phoenix eBook Collection database.