Question

Describe a full revenue cycle process utilizing a personal doctor/dentist visit step by step.

Answer 1

The healthcare revenue cycle is the process through which the ehalthcare organization or private practice professionals regulate their funding and revenues for better and effective profitable services.

The steps on management of healthcare revenue cycle are-

1. Revence cycle management software or outsourcing process- this step helps to plan and decide how the revenue system of the organization will be managed. It includes medical billing, outsourcing and use of software for EHRS.

2. Patient pre-authorization- this step is to ensure that the medication, treatment or tests for the patient is necessary and this decision is to be taken by the p[rofessional for the insuared patient.

3. Eligibility and benefit verification- in this step the patient's eligibility and verification is required. The front office staff helps during this process, the patient's eligibility tgain coverage is checked in this step.

4. Claim submission- The claim has to be submitted for the work done for the patient to the insurance agency. Practice managemetn software is used here to submit claims.

5. Payment posting- AFter successful claim submission, the application is reviewed and payment is posted and is payable by the patient.

6. Denial management- If the claims are denied for any particular cause it is being managed at this stage,

7. Reporting- This step is concerned with reporting of settled claims and the complications or issues oingoing the procedure.