Medical Revenue Cycle

The processes that we focused on this week are the 13 steps that makeup Revenue Cycle Management with an emphasis on tracking patient services, charges, payments, and adjustments.

1. Review the 13 steps as displayed in your text on page 63.

2. Slide 25 in this week’s PowerPoint lists the reasons that an insurance claim may be denied.

Articulate the revenue cycle of an insurance claim.

Include the following aspects in the discussion:

· Name two of the most important steps in the revenue cycle for the billing specialist and explain your choices.

· Name the reasons for insurance denials that you believe the billing specialist is responsible for and why.

· Discuss the downstream impact that might occur for the patient if any of the processes of this cycle are not followed.

· Discuss the downstream impact that might occur for the provider if any of the processes of this cycle are not followed.

· Explain the impact that might occur to the cash flow of the facility or provider if any of the processes in this cycle are not followed.

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