Describe the revenue cycle. Then identify a operational tactic that you feel might improve or tighten the cycle.
"The revenue cycle is set of recurring and related business and related information processing necessary to bill for and collect revenues due for services provided"( gapenski p 582).The importance of the revenue cycle is due to the fact that providers do not get paid with cash at the time of service. Therefore, costs are incurred but there is not immediate payment to cover costs. Providers can wait extended periods of time to received payment. The importance of the revenue cycle is to optimize the collection of receivables owed to providers.
The revenue cycle must be managed . It should be mechanized with everyone in the operational chain understanding there role. There can be several steps in the management of the revenue cycle. They include he preservice management, to management of claims, denials and posting.
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That is accurate data is critical to every step that follows. Without accurate data, correct data, or incorrectly entered data, the claims when processed will be rejected. At that point, which could be weeks or months after the service, that the staff( requiring more time and cost) will need to contact the patient , correct the information and reprocess the claim. The longer from the service the less likely to collect and therefore a loss is encountered.
“From a revenue cycle perspective, getting the most accurate information up front starts with patient scheduling and patient registration. That provides the groundwork by which claims can be billed and collected in the most efficient and effective manner possible,“The last thing you want is getting a claim submission kicking back to them then having to work their way through the
On the basis of the clinic’s previous collections experience, Dough was able to convert billings for medical services into actual cash collections. On average, about 20% of the clinic’s patients pay immediately for services rendered. Third-party payers pay the remaining claims, with 20% of the payments made within 30 days and the 60% remainder (of total billings) paid within 60 days. For monthly budgeting purposes, 20% are assumed to be collected one month after the billing month, and 60% are assumed to be collected two months after the billing month.
As for Intermediate: Build Booths so customers can rate satisfaction on scale from 1-10, build complaint boxes for employees in staff room, take note of sales values, and implement changes to organizational structure. For the Short term: plot result, extrapolate, and gather information if negative results. For the Long term, if results maintain positive relation, the strategy has been successful.
The way in which healthcare organizations need to implement a new strategy into their A/R departments comes from the realization that time of registration is the best time to ask the patient for payment (Souza& McCarty, 2007). Front end staff in the healthcare industry has not been responsible for collecting payment from the patient before services are rendered; that responsibility has been that of the A/R staff. There have been other healthcare organizations that have found solutions to problems within their A/R departments. Sutter Health was successful in identifying problems in their A/R department, finding solutions for those problems in their A/R department and implementing their solution program into their company. Sutter Health has set themselves up for continued success in their A/R department.
The first business principle that is associated with patient and system cost is manage cash flow very closely (Fisher,
I suspect that the codes that the physicians are submitting for payment are not accurate. Entering inaccurate codes that will yield the highest revenue for the clinic is called “upcoding”.
The chargemaster is an integral element of the revenue cycle. It is used in generating charges for services that are rendered to patients in real time, the absence of functioning chargemaster can result in potential collapse of the revenue cycle. Hence, the process to optimize revenue cycle must include optimizing the chargemaster and all services that is associated with it. The negative consequences of nonfunctioning chargemaster can include excessive payment/overcharging, inaccurate billing to patients; and can result in stiff penalties and fines (Bielby et al,
First, revenue comes from customers. We are pretty good at "tuning our radar" to what turns on/off our boss who has power over our salary and career progress, so it makes sense to likewise tune our radar to our ultimate boss: customers. This is the Customer Voice building
Revenue cycle. For revenue cycle recording, Sage 50 allows the user to go through a pipeline of stages that need to be accomplished. The user enters customers into the system. The system keeps track of customers individually. This information may be updated in the future.
However, patients should register again and keep waiting for the specialist out-patient clinics. In light of the evidence, a streamlined process is being implemented so as to minimize the patient time. Based on the given reference, it is probable that services diminish the time externally. In fact, patients seem to be just waiting for help. Predictability :
The Six stages of the revenue cycle are provision of service, documentation of service, establishing charges, preparing claim/bill, submitting claim, and receiving payment. The first step consist of providing the ...
When you have a strategy that addresses your both your cost management and revenue generation concerns, you will have the best solution to the profitability
They are many different alternative solutions that businesses can do in order to try and jump starts their declining sales. One of the way can start with is to see what do their customers really want. This can done easily by having their
patient by a few more weeks or months, they do nothing to return a patient to a
OPERATION AND OPERATIONS MANAGEMENT All organizations have operations.” A manufacturing company may conduct operations in a foundry, mill, or factory. Our interest is in the management of operations, or operations management (OM), including the usual management cycle of planning, implementing, and monitoring/controlling. The driving force for OM must be an overriding goal of continually improving service to customers, where customer means the next process as well as the final, external user. § Since there is an operation element in every function of the enterprise, all people in all jobs in every department of the organization should team up for improvement of there own operations management elements. Teaming Up with Customers What happens when suppliers and customer are disconnected? Consider design work, for example. Whether we speak of goods or services, time- and distance separation in the supplier-customer connection invites trouble. Question: “What’s your Job?” Question: “But isn’t your job to serve the customer?” In grocery stores, where the supplier-relationship is immediate, the operations manager system is hard pressed to maintain a customer focus. The customer is the next process, or where the work goes next. A buyer’s customer is the associate in the department to whom the purchased item goes; a cost accountant’s customer is the manager who uses the accounting operations-where the design will be produced or the service provided. It is also clear that throughout the organization, people not only have customers, they are customers. Let’s turn our attention to what customers want. A Short List of Basic Customer Wants The requirement is a recipient’s or customer’s view of a good or service. A close partnership with the customer’s actual requirements. A close partnership with the customer helps create good specifications, increasing the supplier’s ability to fulfill the customer’s needs. What else do customers want? Customers have six requirements of their providers: High levels of quality. High levels of service. Low costs. OPERATIONS STRATEGY An organizational commitment with wide ranging effects, such as continuing improvement in meeting customer needs, is called a strategy. Strategy itself is necessary because of competition, and successful strategy ensures that company strengths match customer requirements. Integrated Business Strategy To accomplish its aims, the business team must plan strategy in all four-line functions. A comprehensive strategic business plan deals with issues affecting the whole organization: employees, markets, location, line of products and services, customers, capital and financing, profitability, competition, public image and so forth.
Answer - There are usually two issues regarding the revenue. One is about the volume and other one is about the cost. So one person will focus on the volume while the other one will be focusing on cost. There is a part where the problem statement is divided among the people. These sub parts of the problem are managed by a single person or many people depending on the difficulty level.