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 oversees compilation of charges, billing, and collections (Davis, 2011, p. 3).
The flow of activities that makes up the revenue cycle is basically the same for most health facilities. They are ordered as follows: patient intake, clinical services, charge capture, billing, and collections. Patient intake, also known as patient registration, is the front end of the revenue cycle. Some of