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Revenue Management

Management of the revenue cycle is a huge portion of measuring the success of a private practice.   This page of the site is dedicated to offering information and addressing issues regarding medical billing, coding, information gathering, payer information, credentialing, claims transmission, denial management, appeals and reporting.  

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Healthcare Financial Management Association:

• PDF on Improving Cash Flow 

Articles

Exerpt from "A Fair Way to Reduce Charitable Care" from HFMA: 
        " Intermountain personnel received extensive training, support, and feedback through audits to ensure FAIR processes became embedded into daily operations. Patient account services personnel were trained to promote patient friendly interactions and to educate patients on their financial responsibilities and financial options. Preregistration and registration staff were trained to ask patients for deposits and to explain financial assistance requirements.In addition, the team established metrics to benchmark FAIR processes and monitor process performance. Metrics and performance are reviewed at weekly and monthly meetings to track the effectiveness of the solution and its results. Key metrics include:

• The percentage of scheduled patients who are financially compliant
  
• The extent to which financial responsibility is resolved before scheduled patients receive care
  
• The volume of uninsured accounts that are screened in the ED
  
• The amounts that patient account services representatives collect up front
  

Improved communications between financial and clinical staff, as well as clearer procedures and information system enhancements, encouraged their collaboration in rescheduling nonurgent services to allow patients to participate in Medicaid or Intermountain's charity care program. This collaboration often resulted in increased teamwork on other initiatives as well."