Description

Discussion: Revenue Cycle Components

In healthcare, the revenue cycle is defined as “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue” (Oregon Health and Science University, 2018). Processes like charge capture, claim submission, and third-party follow-up are all part of the revenue cycle, and the proper execution of each process leads to a predictable path of revenue. Errors, especially at the beginning of the cycle, can lead to problems that can ripple throughout the process and delay reimbursement or cause additional costs to recover funds.

In this Discussion, you create an infographic to analyze components of the revenue cycle and describe how different departments work together within components.

References:
Oregon Health and Science University. (2018). Revenue cycle. Retrieved from http://www.ohsu.edu/xd/about/services/patient-busi…

To prepare for this Discussion:

  • Review this week’s Learning Resources.
  • Choose one of the following revenue cycle management components on which to focus for this Discussion:
    • Insurance verification
    • Prior authorization and precertification
    • Financial counseling and patient pay
    • Medical necessity
    • Case management and utilization management
    • Charge description master and charge capture
    • Coding and clinical coding improvement
    • Claims processing, payment posting, and denial management
    • Quality measures for improvement
  • Review the assigned chapters from Harrington (2021) and identify and review at least two current, scholarly articles (less than 5 years old) from the Walden library for information on the topic you chose.
  • Review the following examples of infographics. Consider their creativity and flow as you are creating your own infographic:

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