HIT 235 | Week 2 Study Guide
HIT 235
WEEK 2 STUDY GUIDE
Health Care Finance & the Revenue Cycle
Module 2: Reimbursement Processes & Tools + Health Care Finance as a
Strategic Resource
Lesson 1 From Scheduling to Payment: Revenue Cycle Tools in EHRs
Lesson 2 Understanding the Essentials of Health Care Finance in the Revenue Cycle
Reimbursement processes, payers, payment methods, financial
Chapters 2–3
statements, budgets, and communication tools
Designed for review, quizzes, the EHR Go activity, and the Week 2 discussion
Page 1
, HIT 235 | Week 2 Study Guide
QUICK MAP OF WEEK 2
Section What to Study
1 Module Overview and Big Picture
2 Lesson 1: EHRs, CDI, Documentation, and Reimbursement
3 Lesson 2: Revenue Cycle Finance and EHR Support
4 Chapter 2: Payers, Payment Models, MPFS, ACOs, and AI Coding
Chapter 3: Revenue, Expenses, Financial Statements, Budgets, and Patient Financial
5
Notices
6 EHR Go Activity: Liu Huang Case
7 Confirmed Knowledge Check Answers
8 Practice Review and Answer Key
9 Night-Before Cram Sheet
📘 How to use this guide
Read the bold terms first, then study the process tables. Use the confirmed answer section to check
your understanding, and finish with the practice review. The last-page cram sheet is designed for a
fast final review.
🎯 Module objective
Analyze the key components of health care finance, including the revenue cycle, reimbursement
tools, payer models, EHR support, clinical documentation improvement, and financial reporting.
Page 2
, HIT 235 | Week 2 Study Guide
1. Module Overview and the Big Picture
You will learn: health care reimbursement processes and tools, plus health care finance
fundamentals.
Learning activities: Lesson 1, Lesson 2, Chapters 2 and 3, discussion, knowledge checks,
EHR Go activity, and pulse survey.
Discussion focus: how artificial intelligence can support billing, coding, claims, denial
prevention, and reimbursement accuracy.
💡 The revenue cycle in one sentence
The health care revenue cycle is the connected series of clinical and administrative steps that turn
a patient service into an accurate claim and, eventually, payment.
A. The Revenue Cycle: Simplified Four-Step View
Step What Happens Financial Connection
1. Service The service must be documented before
The physician examines and treats the patient.
provided it can be coded and billed.
2. Coding and Diagnoses and procedures are coded; charges Incomplete coding can delay the bill and
billing move to accounts receivable. increase DNFB.
3. Claim The payer reviews the claim under policy and Errors, missing data, or authorization
submitted contract rules. problems may cause rejection or denial.
4. Payment Payment is posted; secondary payer or patient The organization follows up on
remitted balance is billed. remaining balances and denials.
⚠ DNFB: Discharged Not Final Billed
A bill cannot be finalized until coding is complete. Records that miss the hospital bill-hold window
may appear on the DNFB report. Common reasons include incomplete diagnosis/procedure coding,
missing data, charges not linked correctly, or invalid revenue code/payer information.
📉 A/R days
Accounts receivable days measure the average time between discharge and receipt of payment.
Lower A/R days generally indicate healthier cash flow.
B. Mia’s Six-Step Journey: From Check-In to Payment
Step Stage How the EHR Helps
Preregistration and insurance Verifies insurance in real time, flags eligibility issues, and
1
verification reduces unexpected bills.
Page 3
HIT 235
WEEK 2 STUDY GUIDE
Health Care Finance & the Revenue Cycle
Module 2: Reimbursement Processes & Tools + Health Care Finance as a
Strategic Resource
Lesson 1 From Scheduling to Payment: Revenue Cycle Tools in EHRs
Lesson 2 Understanding the Essentials of Health Care Finance in the Revenue Cycle
Reimbursement processes, payers, payment methods, financial
Chapters 2–3
statements, budgets, and communication tools
Designed for review, quizzes, the EHR Go activity, and the Week 2 discussion
Page 1
, HIT 235 | Week 2 Study Guide
QUICK MAP OF WEEK 2
Section What to Study
1 Module Overview and Big Picture
2 Lesson 1: EHRs, CDI, Documentation, and Reimbursement
3 Lesson 2: Revenue Cycle Finance and EHR Support
4 Chapter 2: Payers, Payment Models, MPFS, ACOs, and AI Coding
Chapter 3: Revenue, Expenses, Financial Statements, Budgets, and Patient Financial
5
Notices
6 EHR Go Activity: Liu Huang Case
7 Confirmed Knowledge Check Answers
8 Practice Review and Answer Key
9 Night-Before Cram Sheet
📘 How to use this guide
Read the bold terms first, then study the process tables. Use the confirmed answer section to check
your understanding, and finish with the practice review. The last-page cram sheet is designed for a
fast final review.
🎯 Module objective
Analyze the key components of health care finance, including the revenue cycle, reimbursement
tools, payer models, EHR support, clinical documentation improvement, and financial reporting.
Page 2
, HIT 235 | Week 2 Study Guide
1. Module Overview and the Big Picture
You will learn: health care reimbursement processes and tools, plus health care finance
fundamentals.
Learning activities: Lesson 1, Lesson 2, Chapters 2 and 3, discussion, knowledge checks,
EHR Go activity, and pulse survey.
Discussion focus: how artificial intelligence can support billing, coding, claims, denial
prevention, and reimbursement accuracy.
💡 The revenue cycle in one sentence
The health care revenue cycle is the connected series of clinical and administrative steps that turn
a patient service into an accurate claim and, eventually, payment.
A. The Revenue Cycle: Simplified Four-Step View
Step What Happens Financial Connection
1. Service The service must be documented before
The physician examines and treats the patient.
provided it can be coded and billed.
2. Coding and Diagnoses and procedures are coded; charges Incomplete coding can delay the bill and
billing move to accounts receivable. increase DNFB.
3. Claim The payer reviews the claim under policy and Errors, missing data, or authorization
submitted contract rules. problems may cause rejection or denial.
4. Payment Payment is posted; secondary payer or patient The organization follows up on
remitted balance is billed. remaining balances and denials.
⚠ DNFB: Discharged Not Final Billed
A bill cannot be finalized until coding is complete. Records that miss the hospital bill-hold window
may appear on the DNFB report. Common reasons include incomplete diagnosis/procedure coding,
missing data, charges not linked correctly, or invalid revenue code/payer information.
📉 A/R days
Accounts receivable days measure the average time between discharge and receipt of payment.
Lower A/R days generally indicate healthier cash flow.
B. Mia’s Six-Step Journey: From Check-In to Payment
Step Stage How the EHR Helps
Preregistration and insurance Verifies insurance in real time, flags eligibility issues, and
1
verification reduces unexpected bills.
Page 3
