Please provide a comment for about 3-5 sentences regarding the discussion below. Please use APA and peer-reviewed resources. Thank you.
Healthcare capital and revenue management could be one of the most important components to running a successful organization. After all, one cannot thrive without a capable and quality revenue management system. The article I chose to review this week is directly from the Oregon Health & Science University. In this overview it explains how breakdown of revenue cycle. I found it useful because it explains clearly how revenue cycles in healthcare function. It defines the healthcare revenue system as “All administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” (OSHU, 2018). The encapsulates the life of the account from the moment it is created to it’s closing or payment. There are many moving parts to the revenue cycle ranging from scheduling, utilization management, claim submission, and third party follow-up. Discussed is the importance of executing the process correctly to ensure there are no problems that can have detrimental consequences to the organization. An error must be caught and remedied quickly. The further it travels through the cycle the more difficult it becomes to recover. There are several terms that are specific to revenue cycle, which this article refers to. When an item is documented it is termed charge capture; these can be entered either manually or electronically through a coding system, which translates descriptions of diagnosis and clinical information into universal medical language. The coding system also assists with getting organizations paid through the Medicare and Medicaid systems. Especially if an organization is Medicaid capitated they cannot run the risk of coding diagnosis’s or services incorrectly because if they do, they may not get paid their allotted amount. The process does not just stop at getting paid despite what one may think. There must be contact with third parties, and after which those parties are contacted to gain the revenue that has been filed with the insurance company, it goes to utilization review. The article explains utilization review as the assessment of the utilization of services. The step in the revenue cycle process evaluates the efficiency and appropriateness of the services and facilities used. This evaluation can include the length of stay, what services are provided, and the referrals to outside agencies(Revenue cycle, 2018).
Revenue Cycle. (2001-2018). Patient Business Services. Retrieved from http://www.ohsu.edu/xd/about/services/patient-busi…