Revenue Cycle - ICD10monitor
February 2, 2021
Whose Territory is it Anyway?
COVID-19 has added another level of complexity to the revenue cycle. Hospitals and health systems need to update their current revenue cycle processes, becoming more efficient in that arena. Revenue cycle must eliminate inefficient processes in order to drive revenue preservation that translates into optimal net patient revenue. These changes…
August 18, 2020
Role-Based Versus Task-Based Clinical Documentation Integrity: A Major Determinant of Operational Performance
The CDI profession has failed to effectively articulate its value in the revenue cycle. Role-based versus task-based business processes can play a major role in driving operational performance of any department or organization. From a business perspective, each department of a company or firm contributes to the overall success and…
July 23, 2019
Why the Mid-revenue Cycle is Now Under Scrutiny
Mid-revenue cycle is becoming increasingly important for driving financial stability. How do you define revenue cycle management (RCM)? Have you clearly delineated what is included in the front, middle, and back of RCM for your facility? You must do so before you can appropriately address the resource requirements for each…
June 18, 2019
The Revenue Cycle for Skilled Nursing Facilities
Big ICD-10 changes coming soon to the SNF world. In July 2018, the Centers for Medicare & Medicaid Services (CMS) finalized a new case-mix classification model, the Patient-Driven Payment Model (PDPM), which, effective beginning Oct. 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS)…
How to enhance edits to achieve clean claims. The effective use of edits within a healthcare organization’s billing system may permit such organizations to not only identify documentation, billing, and coding issues to address, but also facilitate achieving an improved clean claim rate. A clean claim is one that meets…
April 30, 2019
The Role of HIM Professionals in the Revenue Cycle
HIM professionals touch many functions of the revenue cycle. As we continue this segment on health information management (HIM) in the revenue cycle, I’d like to share some thoughts I discussed at the recent Missouri Health Information Management meeting. When we think about the functions that compose the revenue cycle…
March 5, 2019
Getting into the Revenue Cycle Groove: Part 1
Pursuing revenue cycle roles could be an ideal path for HIM professionals. Often, we see patient financial services staff progress to leadership positions in the revenue cycle. When I have the opportunity to serve in such positions, I always wonder why we don’t see more health information professionals in these…
January 22, 2019
Understanding CMS Advanced Practitioner Professional Billing
Not billing the APP service can result in serious revenue cycle errors. Many providers are still struggling with the non-physician practitioner (NPP) billing rules from the Centers for Medicare & Medicaid Services (CMS). Most facilities are now referring to NPPs as Advanced Practitioner Professionals or APPs. I get questions all…
The “right documentation” is the central pivot point to the revenue cycle Physician clinical documentation plays a critical role in any overall healthcare delivery model, including the life of the revenue cycle, which drives reimbursement for quality medical care provided to patients. The revenue cycle is defined by the…
April 24, 2018
Holistic Approach to CDI Appears Promising
Each patient’s story should be told in the official record. The clinical documentation integrity (CDI) profession has only scratched the surface of instilling positive change in patterns of physician documentation and communication of patient care. There exists a myriad of opportunities for CDI specialists to capitalize upon and truly improve…