Revenue Cycle Steps
In the management of the revenue cycle in the healthcare environment, we have four clear steps: establishing effective policies and procedures, implementing/evaluating an accounting system, implementing/evaluating a medical records system, and implementing/evaluating a credit and collections system. Each of these steps are central to the success of the organization, and any weakness at just one of the steps leaves your organization critically vulnerable.
The passing of HIPAA (as a transactional standard) gives us the unique opportunity to improve revenue cycle performance. As you grow in financial managerial skills, it will help you to conceptualize the revenue cycle as a continuum, instead of a set of isolated happenings. This Module’s Case will challenge you to study each of the four steps, and then explain their central nature to organizational success.
Case Assignment
After completing the required readings:
- What are the four distinct steps of the revenue cycle?
- How does each portion of the cycle specifically support organizational success?
- How does the economic status of the patient population and the patients’ ability to pay impact revenue cycle and viability of the organization?
- How can revenue cycle management be improved using the five key areas noted by Dr. Nowicki (2018; see required background reading)?
- Which step do you feel your organization (or most organizations) struggles with the most, and why? Be as specific as you can in your explanations.
Assignment Expectations
- Conduct additional research to gather sufficient information to support your analysis.
- Provide a response of 3-5 pages, not including title page and references.
- As we have multiple required items to be addressed herein, please use subheadings to show where you’re responding to each required item and to ensure that none are omitted.
Support your responses with peer-reviewed articles, with 2 to 3 references.
Case 3 BHA427: Revenue Cycle Management
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Case 3 BHA427: Revenue Cycle Management
The healthcare system’s financial health is a fundamental component that demands increased stakeholder examination. Nowicki (2018) indicates that effective management of these systems determines the capability of healthcare facilities to remain stable, adequately prepared, and equipped to provide sufficient services to their patients during routine care or in emergent situations. Although healthcare institutions receive finances from diverse channels, accounts receivable cover many of these avenues. Nowicki (2018) describes accounts receivable as the money owed to these entities by the patients and their payor or the insurance companies after providing healthcare services. Financial experts require health institutions to maintain a healthy revenue cycle for the efficient collection of revenue critical for continued care. Thus, this paper explores the revenue cycle’s steps, their support towards organizational success, mechanisms of improving them, and areas many institutions find challenging to implement.
Revenue Cycle’s Four Primary Steps
The management of a healthcare institution follows particular steps in establishing a distinguished revenue cycle. According to Nowicki (2018), stakeholders should first formulate appropriate policies and procedures for guiding the process of registering and admitting patients. Creating such documents streamlines the process of information collection from non-emergent patients through preadmission or preregistration. The author notes that such a process facilitates payment collection before providing healthcare services. Nowicki (2018) underlines that implementing such a