Tour de Finance: Managing the revenue cycle-Tour de Finance

Tour de Finance

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The article "Tour de Finance: Managing the Revenue Cycle" by Mark Harris underscores the importance of effectively managing the revenue cycle in healthcare to ensure the financial health and operational viability of medical practices. The revenue cycle encompasses every administrative and clinical step necessary from a patient's initial appointment booking to the final collection of payment for services rendered. <br /><br />The evolving landscape of healthcare reimbursement, including the shift towards value-based reimbursement models, presents ongoing challenges. This model integrates cost, patient satisfaction, chronic disease management, and evidence-based care processes into provider payments, contrasting with the traditional fee-for-service model. The U.S. Department of Health and Human Services plans to integrate value-based reimbursements into Medicare payments further, emphasizing the importance of adapting to these changes.<br /><br />Kenneth T. Hertz from the Medical Group Management Association highlights two crucial aspects of optimal revenue cycle management: understanding payer contracts thoroughly and knowing the office technology, including practice management systems and electronic medical records. David J. Zetter, a practice management consultant, suggests practices should update financial policies to accommodate high-deductible health plans, recommend upfront collections, and implement credit card on file policies for managed patient payments securely.<br /><br />The article also discusses the significant impacts of the ICD-10 code adoption, which demands detailed documentation and precise coding to ensure effective revenue cycle processes. Staff must be well-trained and equipped with resources like crosswalk charts to successfully transition from ICD-9 to ICD-10. <br /><br />Moreover, Hertz and other experts advocate for strong communication within practice teams to tackle issues like denied claims efficiently and stress the role of trained financial counselors in guiding patients through their financial obligations.<br /><br />The bottom line is that successful revenue cycle management hinges on meticulous attention to details, continuous education, and adaptation to new financial realities, all while maintaining a patient-centered approach.

Keywords

revenue cycle management

healthcare reimbursement

value-based reimbursement

payer contracts

practice management systems

electronic medical records

ICD-10 code adoption

high-deductible health plans

financial policies

patient-centered approach