Ch8

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Managing and Improving the
Hospital Revenue Cycle Process
The objectives related to successful revenue cycle management
are as follows:
•Improve cash flow
•Increase revenue
•Lower bad debt expense
•Improve patient/customer satisfaction with financial services
•Reduce operating cost
•Increase productivity
•Reduce the possibility of extended patient stays
•Understand problem areas and implement improvements
Issues impacting the revenue cycle
• Impact of consumer-driven health
• Competing high-priority projects
• Lack of skilled resources in several areas
• Narrowing margins
• Significant market changes
• Limited access to capital
• Need to optimize revenue: There are five core areas that hospitals
must examine carefully:
• International Classification of Diseases–Tenth Edition (ICD-10):
• System integration:
• Clinical documentation:
• Billing and claims management:
• Contract analysis:
The following lists provide a few critical areas in which technology
has improved revenue management operations:
- Patient Access
• Call center capabilities with auto dialing, faxing, and Internet.
• Master Patient Index software to eliminate duplicate medical
record numbers.
• Registration and admission software.
-Health Information Management
• Chart-tracking software.
• Encoding and grouper software to improve
coding accuracy.
• Auto-printing and faxing capabilities.
• Internet connectivity for release of information.
• Electronic management of documents.
- Patient Financial Services
•Automated biller.
• Claims scrubbing software.
• Electronic claims
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