Healthcare Revenue Cycle Management
This means that healthcare organizations need to develop efficient processes and policies which would allow them to save lives and treat patients in the most suitable ways. Through the use of healthcare revenue cycle management, healthcare organizations can efficiently identify, manage, and collect patient service revenue (Ginter et al. This report seeks to discuss the challenge of billing and accounting errors in the healthcare revenue cycle management. It will also illustrate the setbacks triggered by this issue in healthcare organizations. The paper will demonstrate how this issue adversely affects the activities and success of healthcare organizations in the provision of quality healthcare. Description of the problem Failures in capturing patient information There are various aspects which trigger billing and accounting errors in a healthcare organization’s revenue cycle.
For instance, the billing and accounting errors might be caused by failure to capture patients’ details. Kennedy, Wood, and Ledlow (2016) propose that in this case, it should be noted that the healthcare billing approach usually begins at the initial aspect of involvement between patients and their corresponding healthcare organizations. In this interaction, individuals working as the front-end staff are required to obtain patient details. The patient information is crucial in laying the background for billing and collecting payment. The issue is further triggered by the fact that 90 percent of 12. 7 million people in the United States are under the high-deductible insurance plan (Ward & Calabrese, 2018). The plan shifts healthcare payment responsibility to the clients rather than the payers. In this scenario, healthcare organizations encourage billing and accounting errors in the revenue cycle management by failing to appropriately the patients about their roles in catering for the provision of patient care.
Use of Manual claims management processes In the modern era of advancements in technology, some healthcare organizations are still depended on manual operations in the claim management processes. Inaccurate coding is mostly encountered in the use of Electronic Health Records (EHRs). Medical providers might have issues with entering data using EHRs. Hence, the application of EHR shortcuts might result in significant damage to both physicians and patients, especially the healthcare organization (Gartee, 2016). Inaccurate coding leads to billing errors especially in situations when there are issues in submitting accurate claims. Therefore, improper usage of codes when making hospital payments and assessing values in physician reimbursement. The rationale for the possible solutions presented herein is that implementing them would assist in preventing the triggering aspects from occurring.
The solutions would be vital in mitigating the adverse effects that healthcare organizations might encounter because of the problem of billing and accounting errors. Following Coding Guidelines A good understanding of coding guidelines and billing approaches would be essential verifying that claims made are correct. This is vital because some of the medical codes are updated on an annual basis. Hence, taking time to train the front-end staff on the codes would assist to reduce coding errors which prove to be costly in terms of billing and accounting errors in healthcare revenue cycle management (Gartee, 2016). This would be achieved through the healthcare organizations implementing financial regulations which consist of assessing the costs of services and informing the patients about their financial obligations.
This step would help the healthcare organizations in taking the necessary actions for simplification of patient bills. Encouraging the use of automation in claims management As illustrated earlier on, manual claims management processes propagate billing and accounting errors. Therefore, the application of automated claims management processes would be appropriate. This would reduce the number of inaccuracies. The automated accounting and billing processes enhance the formulation of crucial decisions when managing financial and accounting compliance. It is also vital because it increases the productivity of the front-end staff and individuals in the finance departments. This is concerning how they process claims and maintain revenue information for the entire firm. Implementation plan for automation to eliminate billing and accounting errors Since revenues collected in healthcare organizations are critical towards the success of organizations, there is need to implement automation which would appropriately deal with billing and accounting errors.
Before applying automation, the organization should evaluate their unique billing and accounting needs, existing technologies, processes, and the organizations’ potential to drive and adopt change. Also, based on the discussion above, specific solutions can be undertaken to prevent further occurrence of billing and accounting errors in healthcare revenue cycle. However, it is clear that the best approach to eliminate billing and accounting errors is the implementation of an automated process. Besides, the management of healthcare organizations should establish an implementation plan because it would enhance the success of the computerized system in its attempt to counter billing and accounting errors in healthcare revenue cycle. References Gartee, R. Electronic health records: understanding and using computerized medical records. H. , Wood, K. H. , & Ledlow, G.
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