Revenue Cycle: The Devil is in the Details

Whether reviewing a hospital or employed physician network, the devil is in the details when examining the health of the Revenue Cycle (RC) ecosystem. Sometimes figures and reports don’t tell the entire story. What may appear as a sound measurement of days in accounts receivable (e.g., 30 days) can actually mask systemic problems in processes and procedures. If data reported are inaccurate, miscalculated, or outright corrupt, leadership may not discover the issues until revenue wanes.

Stunningly, some provider organizations continue to under-estimate the significance of revenue cycle management and its accompanying components. The process begins at check-in with proper registration and patient intake. It follows the patient in their visit and continues long after the patient has checked out and scheduled their next visit. Nothing is ever as simple as it seems. The front desk and the check-in process impact the revenue cycle when staff collects (or doesn’t collect) copays and deductibles. In reviewing the operations of a medical practice in an attempt to identify the ills, sometimes the answer, while complicated, is right under your nose, yet remains illusory.

Coker’s revenue cycle management work entails all pieces in the process of a provider organization, including, but not limited to, proper utilization and deployment of RC information technology-related systems, review of patient check-in procedures, denials management, validating and verifying accurate payments are received and posted, and examining fee schedules for anomalies. We’ve studied components or complete systems, depending on the need.

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