the revenue cycle involes both

administrative and clinical oversight

the revenue cylcle begins

with patient registration and ends when final payment is made to organization

the revenue cycle components

appointment scheduling, patient registration, charge capture

revenue cycle components

code assignment, collecting patient financial portion, posting charges and patient payments

revenue cycle components

claim creation and submission, insurance payment posting, initiating appeals

revenue cycle components

patient billing, patient payment posting, collection and posting collection payments.

the amount owed to a healthcare provider for services rendered.

denial claims- possible errors - front office

eligibility error or data entry error

denial claims- possible errors -billing / coding errors

code linkage error or preauthorization not obtained.

denial claims- possible errors- back-office errors

documentation error or missing/ incomplete encounter form documentation.

revenue cycle management engages a variety of stakeholders and is

vital for ensuring the financial stability of a healthcare organization

registration and scheduling- step 1

the patient provides basic dermographia and insurance information

step 2 patient check in

Review demographics and insurance information Review of outstanding balances and post payments such as copayment, Appointment arrangement and confirmation, medical release record forms signed, HIPPA signed, assignment of benefits signed.

utilization management review step 3

can occur at check in or check out its a review process to determine when referrals or preauthorization may be required. precertification and screening for medical necessity are a part of this process.

health care encounter and documentation step 4

patient encounter is preformed and supporting documentation is entered into patient recod

step 5 charge capture and coding

process of selecting and entering codes based on the documentation in the patients record and then entered into the financial portion or the practice management system of the EHR electronic health record

step 5 patient check out

determines additional out of pocket expenses, follow up appointment, referrals, consent form reviews. sometimes utilization management review

what is a third party payer

a healthcare insurance company that reimburses services provided by providers and other healthcare organization

A licensed professional who can submit claims to a third party payer. such as a physician, therapist, hospital

Help

Options

focusNode

Didn't know it?
click below

Knew it?
click below

Don't Know

Remaining cards (0)

Know

retry

shuffle

restart

0:00

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

Normal Size Small Size show me how

NHA study

Question	Answer
the revenue cycle involes both	administrative and clinical oversight
the revenue cylcle begins	with patient registration and ends when final payment is made to organization
the revenue cycle components	appointment scheduling, patient registration, charge capture
revenue cycle components	code assignment, collecting patient financial portion, posting charges and patient payments
revenue cycle components	claim creation and submission, insurance payment posting, initiating appeals
revenue cycle components	patient billing, patient payment posting, collection and posting collection payments.
accounts receivable	the amount owed to a healthcare provider for services rendered.
denial claims- possible errors - front office	eligibility error or data entry error
denial claims- possible errors -billing / coding errors	code linkage error or preauthorization not obtained.
denial claims- possible errors- back-office errors	documentation error or missing/ incomplete encounter form documentation.
revenue cycle management engages a variety of stakeholders and is	vital for ensuring the financial stability of a healthcare organization
registration and scheduling- step 1	the patient provides basic dermographia and insurance information
step 2 patient check in	Review demographics and insurance information Review of outstanding balances and post payments such as copayment, Appointment arrangement and confirmation, medical release record forms signed, HIPPA signed, assignment of benefits signed.
utilization management review step 3	can occur at check in or check out its a review process to determine when referrals or preauthorization may be required. precertification and screening for medical necessity are a part of this process.
health care encounter and documentation step 4	patient encounter is preformed and supporting documentation is entered into patient recod
step 5 charge capture and coding	process of selecting and entering codes based on the documentation in the patients record and then entered into the financial portion or the practice management system of the EHR electronic health record
step 5 patient check out	determines additional out of pocket expenses, follow up appointment, referrals, consent form reviews. sometimes utilization management review
what is a third party payer	a healthcare insurance company that reimburses services provided by providers and other healthcare organization
formaly called the HCFA-1500 form	CMS 1500 form
what is a provider?	A licensed professional who can submit claims to a third party payer. such as a physician, therapist, hospital

Created by: MommyPooButt

"Know" box contains:
Time elapsed:
Retries: