...Revenue Cycle Management There are many moving parts required to keep any type of healthcare facility running smoothly. Of these, the revenue management process is one of the most important. This is the patient to cash flow within the facility. The process begins when a patient schedules an appointment and ends when all outstanding payments have been collected. While it may seem simple, there is a lot that goes into the process as a whole, and it is a critical aspect of a facility being successful. Let’s start at the beginning and go through the process step-by-step. • Step 1 – Scheduling an appointment: When a patient schedules an appointment, this begins the revenue cycle management process. • Step 2 – Insurance certification: It’s...
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...(1) key factor driving the reduction in revenue. Recommend a revenue strategy for the organization in the scenario to improve its revenue cycle management. Provide support for your recommendation. Patient Revenue Management solutions must efficiently manage the business of transforming patient care into positive financial outcomes. Clinical records must be linked with billing data to ensure proper reimbursements. Rules and embedded certifiable HIPAA EDI transaction sets must drive workflow. Medical billers are incredibly important in every healthcare facility— these providers can't stay in business without good billers. Traditionally, billers have either been trained on the job or have been medical coders who do both the coding and billing. However, the shortage of coders and the growing demand for skilled medical billing specialists has employers looking for professionals who know billing basics. Training with Career Step prepares you for a medical billing-specific career in much less time than it would take if you were gaining coding skills as well. As a medical billing specialist, you will take the data provided by the medical coders and use it to compile and submit claims to insurance companies and then subsequently bill patients. Day-to-day responsibilities vary from location to location, but often include: Using coded data to produce and submit claims to insurance companies Working directly with the insurance company, healthcare provider, and patient to get a claim processed...
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...Assignment: Understanding the Patient Intake Process Name Axia College of University of Phoenix HCR 220 Date Tekne, a Greek word which means an art or craft is where the word technology is derived from. Technology is the study or science of crafting, which are logia. The way in which healthcare is delivered is changing due to clinical information technologies. In an effort to support advancement and innovation of technologies in healthcare, research organizations are creating networks of delivery systems and health plans. The focus of this clinical information technology is centered on a prevention-based, consumer driven model of healthcare. The innovation of new technologies is dependent on many factors: Clinical accountability, consumer demand, research programs, medical advancements, population health targets and the capacity and resources as an industry for technology development. Innovation stimulates the industry to produce large quantities of medical devices and therefore promote them to the healthcare providers. The “clinical pull” of technology, is sometimes impervious with the “technology push" because physicians often resist the change of new technology due to its significance or its impact on day-to-day workflow (Protti, D). With the accessibility of computers, physicians are now able to look up information on his or her patients. Some physicians do not have the capability to write electronic prescriptions or digital health records...
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...interface that was aimed at enhancing revenue collection of the facilities from the self pay patient. The System provides a broad range of health care services, including acute, sub¬-acute, long-term, home health and outpatient care, as well as physician delivery systems. These services are provided through an integrated health care delivery approach which gives the System the ability to deliver a full range of health care products and services to the communities it serves. This network identified that traditional payment processing system had limitations that hindered the effective collecting of revenue. These limitations were associated with limited access to accurate information by the account representatives, ineffective performance measures and fragmented centers of service provision. The Sutter health program developed a system that comprised of solutions geared towards overcoming these limitations. This paper will discuss Sutter Health key problems and issues, solutions, results, accounting practices, alternative approach, informed opinion, and the conclusion. The California Sutter Health Approach Sutter Health is a non- for-profit community based healthcare and hospital system based in Sacramento, CA. Sutter Health faced several problems, but the key problem was, Souza and McCarty wrote an article, "From Bottom to Top: How One Provider Retooled its Collections," that provided data from research indicating how this healthcare system reputed to be on the list of the...
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...The Importance of Proper and Ethical Financial Reporting Within Healthcare Organizations University of Phoenix Mr. Robert Hammer Healthcare Financial Accounting/ HCS 405 June 3, 2013 Healthcare organizations use generally accepted accounting principles to develop a system for conducting accurate and ethical financial reporting practices. Ethical and proper financial reporting practices are essential to the future growth of a healthcare organization; thus, when ethical standards are followed trust is built with the organization’s stakeholders. Not only does ethical financial practices establish trust, but they also ensure that quality care is provided to all clients and patients. Financial reporting provides documentation, records, and an understanding of the inflow and outflow of capital within the healthcare facility, and shows rather a profit or loss is being made within the organization. According to Baker, J.J., and Baker, R.W. (2011). Healthcare Finance: Basic Tools for Nonfinancial Managers, through the four elements of financial management: planning, organizing and directing, controlling, and decision making healthcare organizations can increase revenue, lower expenses, and become leading healthcare providers by achieving their financial goals. Yet, when an organization fails to use ethical financial reporting practices, and the four elements of financial management than it becomes endanger...
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...insurance coverage, a practice can be at risk for decreased revenue and increased financial instability. Fortunately, having an efficient Revenue Cycle Management (RCM) process and integrated electronic health records (EHRs) can help mitigate financial risk. Whether we like it or not, reimbursement policies for physicians and their practices are changing. To stay relevant, independent healthcare providers must keep up or get left behind. A recent article in Healthcare Dive touches upon today's ever-changing regulations...
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...industry is experiencing significant declines in sales due to poor macroeconomic conditions. The Company is well positioned as one of the top-tier firms in the industry, but its business model is highly sensitive to the overall economic cycle. First and foremost, Herman Miller needs to continue to successfully execute its core office furniture business. To reduce its vulnerability to downturns in the overall economy, Herman Miller should work to raise its brand awareness and fully leverage its products in adjacent markets. Recommendations • To ensure that Herman Miller capitalizes on its near 30-year expansion into the healthcare sector, the Company should increase the resources it dedicates towards healthcare and implement the following initiatives: o o Develop a patient bed to enable Herman Miller to offer a complete patient room solution. Consolidate its healthcare distribution network by appointing the best dealers in a given territory and enabling them to offer the Company’s full healthcare product line. Ensure that these dealers are fully trained on the Brandrud and Nemschoff offerings. o Once the office furniture industry rebounds, Herman Miller should begin to consolidate its Brandrud and Nemschoff brands under Herman Miller Healthcare. • To increase brand awareness and sales among non-institutional customers, Herman Miller should enhance its distribution through Costco. o Sell a product through Costco that better represents the Herman Miller brand by offering the Mirra...
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...Prof: Name: Date: April 2016 Assign: Revenue cycle management The articles were about how health care industry using information technology (IT) has affected the hospital and the health care system in general. Healthcare Executives Develop Revenue cycle management (RCM) to effectively control health care system financials. The first article was on intermountain integrates revenue cycle management. Intermountain will be integrating cycle revenue for a large health system. The article explains how difficult it uses to be to administer the cost of health. Todd Craighead intermountain vice president of revenue cycle organization was asked to develop a more effective approach to consolidate the costs. Tom has stated many challenges that providers have accounted before integrating cycle management system. One of the issues were decentralization, each individual hospital had a director. Second was the denial rate was high. The next big challenge was price transparency and patient engagement. After implementing the cycle management there is a more centralized appeals team that has successfully kept denial rates low. Second All Executives report directly through one cycle management. Other directors focus on pre-registration and scheduling. Even there biggest challenge price transparency and patient engagement were consolidated using cycle management. The other article emphasizes the reasons cycle management was implementing and the benefits of the system in health care...
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...Final Business Proposal: Healthcare Kiosks Nephateri White ECO/561 October 12, 2015 Nancy Irizarry Healthcare Kiosks Intro- The healthcare industry is an industry that has endless possibilities as far as innovation is concerned. This is why I think that improving the whole kiosk movement would be worth the capital for hospitals, pharmacies and other medicinal clinics to use. Not only are these industries taking advantage of kiosks, but so are colleges and universities to better help aid students. Kiosks have been introduced throughout the US as early as 2010 for the healthcare industry to utilize for patient check-ins and/or dispersing some medicines to patients. Let’s further discuss how this could be beneficial to the market. Market Structure- It is said that this is a new age for healthcare kiosks. So many people are adept to new and constantly changing technology. The health care industry is one that has proven to be recession free in terms of the business cycle stages. Unaffected by catastrophic events due to the industry making more in dividends and excelling in marginal revenue (Wunker, 2013). Healthcare self-service innovators such as Allscripts and Fujitsu, Clearwave, Nova Medical, HealthAsyst, MedHost, and Interior Health have turned to KIOSK’s custom design expertise to bring new patient check-in solutions to market (Kiosk, 2015). KIOSK’s ability to leverage modular design efficiency and integrate highly custom peripherals has provided these clients with...
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...It is not an understatement to say that the typical Health Information Management (HIM) area plays a critical role in the revenue cycle, largely due to the fact that the revenue cycle begins and ends with medical records (Anderson & Underwood, 2005). The term revenue cycle covers all events that take place in the patient care process that permits the organization to receive payment for the services rendered, and it is important to be aware that this is heavily reliant upon data (Dunn, 2009). In order to fully appreciate the participation of HIM in the revenue cycle process, it is imperative to first gain an understanding of who the key players are, and to summarize the flow of activities that comprises the revenue cycle of a healthcare facility. The key players in hospital revenue cycle management are Administration, Finance, Patient access, Health information management (HIM), Patient accounting, and Clinical services, which includes physicians, diagnostic services, and therapeutic services. Administration sees to strategic goals and operational efficiency and effectiveness. Finance deals with cash flow and contract management. Patient access is responsible for data integrity, demographic and financial data, insurance verification, and pre-certification. Clinical services is responsible for documentation of services, as well as documentation and recording of charges. Health information management takes charge of coding, abstracting, and data validation. Finally, Patient accounting...
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...in Northern California. This network introduced an interface that was aimed at enhancing revenue collection of the facilities from the self-pay patient. This network identified that traditional payment processing system had limitations that hindered the effective collecting of revenue. These limitations were associated with limited access to accurate information by the account representatives, ineffective performance measures and fragmented centers of service provision. The Sutter health program developed a system that comprised of solutions geared towards overcoming these limitations. This paper will discuss the new system created by Sutter Health. The company California Sutter health was found in 1918 and it was known as a not-for-profit healthcare that was created to help the community out. The company headquartered is in Sacramento, California. The Sutter system serves more than one century communities in Northern California. The company started out as a small community-based hospital in California. Later on it become one of the largest healthcare providers in Northern California with the take care of the most patients than any other network. Its affiliate-based system includes 27 acute care hospitals, over 3,400 physicians, 41,000 employees and noted over 2.6 million outpatient visits in 2003. The United States health care system is characterized by huge up front collecting revenue from patients. This situation is brought about by a health care insurance system which entails...
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...something big happening in the healthcare industry, and it seems there is a silver lining to this cloud. Studies say that security, regulatory and privacy concerns might get in the way of cloud computing in the healthcare industry, although this sector is set to grow in the medium term. Cloud computing in healthcare is projected to grow to US$ 5.4 billion by 2017. Modernization in the healthcare system is going beyond Electronic Healthcare Records (EHR). According to research firm MarketsandMarkets, the use of cloud computing in healthcare will span both clinical and non-clinical applications. Apart from EHR, cloud computing will also apply to other clinical uses, such as physician order entry and software imaging and pharmacy use. Non-clinical uses will likewise benefit, including management apps for patient billing, claims and revenue cycle management. According to MarketsandMarkets, the use of cloud computing in healthcare will be greatly beneficial in sharing EHR data across facilities in different geographic locations. Using cloud applications will ensure that patients get treated on time, regardless of location and facility. According to a 2011 study by KLAS Research, 55 percent of hospital executives interviewed said they stored data on the cloud. This included applications like clinical software and email. 71 percent of healthcare providers already deploy, or are planning to deploy, cloud-technology services. However, there is doubt among healthcare providers what cloud computing...
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...IQMS – At a Strategic Turning Point? IQ Medical Services (“IQMS”) A Live Case Prepared for Florida Intercollegiate Graduate/MBA Business Case Competition Laura Kozloski Steve Barnett Executive Summary IQ Medical Services (“IQMS”) is based in Miami, Florida, and was founded in 2007. It is an ISO 9001:2000 certified company that operates globally in collaboration with major healthcare corporations such as General Electric (“GE”) Healthcare. IQMS’ purpose has been to design, construct, and service best-in-class turnkey cyclotron facilities for healthcare systems and academic institutions worldwide; their vison – how they “see” they can accomplish this mission – has been to partner with cyclotron manufacturers such as GE and Siemens. Cyclotron facilities produce contrast media drugs known as FDGs (FluoroDeoxyGlucose) that are injected into patients to detect and diagnosis serious medical conditions. The most common usage is for PET studies, which are diagnostic procedures to determine the extent to which cancer may have spread within a patient’s body. IQMS has partnered with a variety of cyclotron equipment manufacturers accounting for 80% of the 65 projects IQMS has completed in over 30 countries worldwide since 2007. IQMS’ core expertise includes: PET/SPECT Radiopharmaceutical contrast media injection production Equipment selection, procurement and installation, start-Up and qualification with integrated multivendor warranty and service solutions FDA and equivalent regulatory...
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...IQMS – At a Strategic Turning Point? IQ Medical Services (“IQMS”) A Live Case Prepared for Florida Intercollegiate Graduate/MBA Business Case Competition Laura Kozloski Steve Barnett Executive Summary IQ Medical Services (“IQMS”) is based in Miami, Florida, and was founded in 2007. It is an ISO 9001:2000 certified company that operates globally in collaboration with major healthcare corporations such as General Electric (“GE”) Healthcare. IQMS’ purpose has been to design, construct, and service best-in-class turnkey cyclotron facilities for healthcare systems and academic institutions worldwide; their vison – how they “see” they can accomplish this mission – has been to partner with cyclotron manufacturers such as GE and Siemens. Cyclotron facilities produce contrast media drugs known as FDGs (FluoroDeoxyGlucose) that are injected into patients to detect and diagnosis serious medical conditions. The most common usage is for PET studies, which are diagnostic procedures to determine the extent to which cancer may have spread within a patient’s body. IQMS has partnered with a variety of cyclotron equipment manufacturers accounting for 80% of the 65 projects IQMS has completed in over 30 countries worldwide since 2007. IQMS’ core expertise includes: PET/SPECT Radiopharmaceutical contrast media injection production Equipment selection, procurement and installation, start-Up and qualification with integrated multivendor warranty and service solutions FDA and equivalent regulatory...
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...Marketing and Rebranding Marketing Like all other organizations within the health care industry, Novant Health has taken great strides in marketing their company. Novant Health promotes their business through the usage of billboards, television commercials, newpaper articles and ads, magazine ads, brochures, as well as public events and initiatives. Because of such great strides, in 2009, Presbyterian Healthcare, Novant Health, and ABZ Design Group were nationally recognized for advertising and marketing excellence in the 26th Annual Healthcare Advertising Awards, sponsored by Healthcare Marketing Report. Of the awards, the organization brought home Best of Show, four Gold, four Silver, one Bronze, and seven Merit awards (ABZ, 2009). Billboards and Television Commercials Locally, you can find Novant Health Billboards on Interstate 40 going both east and west bound, as well as in and around the metropolitan areas of Winston-Salem and Charlotte. When it comes to television commercials, Novant Health has a broad range of topics that each commercial covers. Recently, Novant Health showcased their extended office hours, convenient locations, and their new video doctor visits within their commercials. One in particular featured former NBA star Michael Jordan. Video Doctor Visits The Video Visits program is the latest of the series of initiatives that Novant Health has used to embrace technology and offer their patients and alternative to the usual face to face...
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