Revenue Cycle and Reimbursement
1. How revenue is generated throughout the healthcare organization
Managing revenue cycle in healthcare organizations involves the processes that controls claim processing, revenue generation and payment. Healthcare institutes generate income through the Fee-For-Service, where patients reimburse for the treatment services offered, and this is the major source of revenue. There is the physician revenue, revenue provided by insurance entities and also government bodies that are connected to the health sectors (Casto and Layman 47).
- Which departments impact revenue and reimbursement?
Finance departments ensure compensation and revenue distribution to the various departments within the healthcare associations. Moreover, the government owned hospitals and healthcare institutes ensure reimbursement and revenue distribution in those specific organizations (Casto and Layman 51).
b. What would happen if no payments were received?
Difficulties would be faced in making payments to the social workers, physicians and the insurance contributions. Additionally, the revenue is necessary for the operational costs within the organizations, such as costs involved in the operational services including the residence, premium and routine services (Casto and Layman 68).
2. How would you describe the interrelationship between the revenue cycle and reimbursement?
The revenue cycle relates to the reimbursement health sector in allocating revenue to the functional departments in the organizations, thus greatly determining the business service performances of the entity. Therefore, the revenue cycle ensures better financial accessibility to the reimbursement sectors, which there-after makes the necessary payments (Davis 42).
3. What seems to be working? (As a Professional)
Considering the expertise gained while learning the impacts value –based healthcare, the Revenue cycle management has a greater responsibility in monitoring and managing the flow of financial resources in the healthcare institutions. It is essential since it helps in improving financial access, responding to the healthcare consumerism costs, improving Payer performance and accelerating cash collection (Davis 54).
4. What seems to need improvements? (As a Professional)
As an upcoming professional in the healthcare sector, as well as having the knowledge of how Revenue Cycle Management is significant, the Revenue Cycle needs improvement. This is because it is important in managing the monitory resource systems of an organization. Applying technology in the process of patient insurance administrations will result to accurate data submissions and less time consumption. Introducing coding software means that there will be electronic remittance and maintenance of electronic health records, which will facilitate a better cooperation between the reimbursement and the Revenue cycle management sectors. These information technology applications can result to an introduction of quality reporting programs by the physicians and the revenue departments, improved health services and medical applications in general (Anderson and Aydin 117).
Anderson, James G, and Carolyn E. Aydin. Evaluating the Organizational Impact of Healthcare Information Systems. New York, NY: Springer, 2005. Print.
Casto, Anne B, and Elizabeth Layman. Principles of Healthcare Reimbursement. Chicago, Ill: American Health Information Management Association, 2006. Print.
Davis, Nadinia A. Revenue Cycle Management Best Practices. Chicago: AHIMA Press, 2011. Print.