H352 REVENUE CYCLE MANAGEMENT
QUESTIONS AND ANSWERS (GRADED
A+)
what is the revenue cycle? - ANSWER-the set of recurring activities and related
information processing required to provide patient services and collect for those
services. It should ensure that patients are properly categorized by payment obligation,
that correct and timely billing takes place, and that correct payment is promptly received
what are the 4 phases that make up the revenue cycle? - ANSWER-1. those that occur
before the service is provided
2. those that occur simultaneously with the service
3. those that occur afterward
4. those that are continuous
why is proper management of the revenue cycle critical to the financial performacne of
healthcare providers? - ANSWER-most healthcare providers do not get paid the entire
bill at the same time services are rendered. Thus, providers incur cash costs for
facilities, supplies, and labor but do not receive immediate payment to cover these
costs. Problems in the revenue cycle lead to lost and late payments, both which
degrade provider revenues and financial condition.
what are the costs of carrying accounts receivables? - ANSWER-the cost of carrying the
receivable amount on the left side of the balance sheet must be financed by a like
amount on the right side. This can lead to interest payments to carry receivables.
how is a firm's A/R balance built up over time. - ANSWER-as providers render services
but do not immediately get repaid. some insurers might not pay back the entire amount
or patient volume and ACP could change resulting in a change for receivables balance.
Claims denials can also back-up or prevent payment
what metrics are used to monitor overall revenue cycle performance? - ANSWER-1.
cost to collect
2. point-of-service collection rate
3. initial denial rate
4. registration quality score
5. charge lag days
what are the problems healthcare providers face in managing receivables? - ANSWER--
billing complexity of third-party payer system (different payment methodologies)
QUESTIONS AND ANSWERS (GRADED
A+)
what is the revenue cycle? - ANSWER-the set of recurring activities and related
information processing required to provide patient services and collect for those
services. It should ensure that patients are properly categorized by payment obligation,
that correct and timely billing takes place, and that correct payment is promptly received
what are the 4 phases that make up the revenue cycle? - ANSWER-1. those that occur
before the service is provided
2. those that occur simultaneously with the service
3. those that occur afterward
4. those that are continuous
why is proper management of the revenue cycle critical to the financial performacne of
healthcare providers? - ANSWER-most healthcare providers do not get paid the entire
bill at the same time services are rendered. Thus, providers incur cash costs for
facilities, supplies, and labor but do not receive immediate payment to cover these
costs. Problems in the revenue cycle lead to lost and late payments, both which
degrade provider revenues and financial condition.
what are the costs of carrying accounts receivables? - ANSWER-the cost of carrying the
receivable amount on the left side of the balance sheet must be financed by a like
amount on the right side. This can lead to interest payments to carry receivables.
how is a firm's A/R balance built up over time. - ANSWER-as providers render services
but do not immediately get repaid. some insurers might not pay back the entire amount
or patient volume and ACP could change resulting in a change for receivables balance.
Claims denials can also back-up or prevent payment
what metrics are used to monitor overall revenue cycle performance? - ANSWER-1.
cost to collect
2. point-of-service collection rate
3. initial denial rate
4. registration quality score
5. charge lag days
what are the problems healthcare providers face in managing receivables? - ANSWER--
billing complexity of third-party payer system (different payment methodologies)
