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Monday, August 6, 2012
  Clinical Accuracy Spoken Here  

Revenue Cycle: Value Driven HC

Many expensive procedures that used to require an inpatient stay are done in the outpatient setting; making outpatient services a significant contributor to revenue for the hospital.

Current Procedural Terminology (CPT) and Healthcare Common Procedural Coding (HCPCS) are the basis for payment.

The change to ICD-10 codes to be implemented by 2014 will impact the hospital revenue cycle.

[Reference: Hospital Revenue Cycle, Module A, Industry Cash Flow]
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  Excellence in Case Mgmt  

Hospital Revenue: Lifting the Veil
on HC Pricing

Hospital departments of case management and finance are creating new policies to manage the increasing consumerism in health insurance.

It's hard for healthcare consumers to learn how much doctor visits or hospital stays will cost them.

Health sites can't give exact prices for medical procedures and services, but consumers can get a rough idea of typical costs in their area. That can help them choose doctors and hospitals, budget for medical costs and sort out disputed bills.

[Reference: Hospital Revenue Cycle, Module A, Industry Cash Flow]
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  Improving Patient Care...  

Hospital Revenue Cycle: Key Roles

Collaboration between the clinical, financial and information services (IS) teams become crucial and can:

  • Improve documentation
  • Enhance workflow processes

Resulting in:

  • Improved reimbursement from government
    and commercial payers
  • Decreased denials

Process mapping a portion of or the entire revenue cycle may be undertaken to help see how the revenue cycle flows within a particular organization. Identification of duplication, fragmentation, overlapping roles and bottlenecks leads to a greater understanding by all involved and leads to process improvements.

[Reference: Hospital Revenue Cycle, Module B, Hospital Cash Flow]
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Tom RasmussenTom Rasmussen
Publisher
Athena Forum
Tom.Rasmussen@AthenaForum.com

 
 

NEW courses coming in 2012

» Sepsis & LOS

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Cathy WrightCathy Wright, BSN, RN
Clinical Editor
Athena Forum

Cathy.Wright@AthenaForum.com

 

 

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