Describe the revenue cycle. Then identify a operational tactic that you feel might improve or tighten the cycle.
"The revenue cycle is set of recurring and related business and related information processing necessary to bill for and collect revenues due for services provided"( gapenski p 582).The importance of the revenue cycle is due to the fact that providers do not get paid with cash at the time of service. Therefore, costs are incurred but there is not immediate payment to cover costs. Providers can wait extended periods of time to received payment. The importance of the revenue cycle is to optimize the collection of receivables owed to providers.
The revenue cycle must be managed . It should be mechanized with everyone in the operational chain understanding there role. There can be several steps in the management of the revenue cycle. They include he preservice management, to management of claims, denials and posting.
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That is accurate data is critical to every step that follows. Without accurate data, correct data, or incorrectly entered data, the claims when processed will be rejected. At that point, which could be weeks or months after the service, that the staff( requiring more time and cost) will need to contact the patient , correct the information and reprocess the claim. The longer from the service the less likely to collect and therefore a loss is encountered.
“From a revenue cycle perspective, getting the most accurate information up front starts with patient scheduling and patient registration. That provides the groundwork by which claims can be billed and collected in the most efficient and effective manner possible,“The last thing you want is getting a claim submission kicking back to them then having to work their way through the
On the basis of the clinic’s previous collections experience, Dough was able to convert billings for medical services into actual cash collections. On average, about 20% of the clinic’s patients pay immediately for services rendered. Third-party payers pay the remaining claims, with 20% of the payments made within 30 days and the 60% remainder (of total billings) paid within 60 days. For monthly budgeting purposes, 20% are assumed to be collected one month after the billing month, and 60% are assumed to be collected two months after the billing month.
Chapter 6 describes revenue determination. Write a 3-4 page paper to include: List and discuss the three payment-determination bases. Explain the difference between a “specific services” payment unit compared to a “bundled services” payment unit. Describe the three major ways that health care providers can control their revenue function. I expect at least 5 secondary sources properly cited and referenced for this paper.
As for Intermediate: Build Booths so customers can rate satisfaction on scale from 1-10, build complaint boxes for employees in staff room, take note of sales values, and implement changes to organizational structure. For the Short term: plot result, extrapolate, and gather information if negative results. For the Long term, if results maintain positive relation, the strategy has been successful.
The way in which healthcare organizations need to implement a new strategy into their A/R departments comes from the realization that time of registration is the best time to ask the patient for payment (Souza& McCarty, 2007). Front end staff in the healthcare industry has not been responsible for collecting payment from the patient before services are rendered; that responsibility has been that of the A/R staff. There have been other healthcare organizations that have found solutions to problems within their A/R departments. Sutter Health was successful in identifying problems in their A/R department, finding solutions for those problems in their A/R department and implementing their solution program into their company. Sutter Health has set themselves up for continued success in their A/R department.
I suspect that the codes that the physicians are submitting for payment are not accurate. Entering inaccurate codes that will yield the highest revenue for the clinic is called “upcoding”.
3. Increase sales to current customers by 5% each year by using innovative technology in order to find more efficient ways to distribute and manufacture our products leading to more competitive pricing.
The 3 percent decline in sales causing a 21 percent decline in profits can be attributed to the identification of the accounting concept of operating leverage. Operating leverage is what business managers apply to boost small changes in revenue into sizable changes in profitability. Fixed cost is the force managers use to attain disproportionate changes between revenue and profitability. Therefore, when all costs are fixed every sales dollar contributes one dollar toward the potential profitability of a project. Once sales dollars cover fixed costs, each additional sales dollar represents pure profit. A small change in sales volume can significantly affect profitability (Edmonds, Tsay, & Olds, 2011). So, therefore, if sales volume increases,
The Six stages of the revenue cycle are provision of service, documentation of service, establishing charges, preparing claim/bill, submitting claim, and receiving payment. The first step consist of providing the ...
However, patients should register again and keep waiting for the specialist out-patient clinics. In light of the evidence, a streamlined process is being implemented so as to minimize the patient time. Based on the given reference, it is probable that services diminish the time externally. In fact, patients seem to be just waiting for help. Predictability :
First, revenue comes from customers. We are pretty good at "tuning our radar" to what turns on/off our boss who has power over our salary and career progress, so it makes sense to likewise tune our radar to our ultimate boss: customers. This is the Customer Voice building
When you have a strategy that addresses your both your cost management and revenue generation concerns, you will have the best solution to the profitability
They are many different alternative solutions that businesses can do in order to try and jump starts their declining sales. One of the way can start with is to see what do their customers really want. This can done easily by having their
patient by a few more weeks or months, they do nothing to return a patient to a
OPERATION AND OPERATIONS MANAGEMENT All organizations have operations.” A manufacturing company may conduct operations in a foundry, mill, or factory. Our interest is in the management of operations, or operations management (OM), including the usual management cycle of planning, implementing, and monitoring/controlling. The driving force for OM must be an overriding goal of continually improving service to customers, where customer means the next process as well as the final, external user. § Since there is an operation element in every function of the enterprise, all people in all jobs in every department of the organization should team up for improvement of there own operations management elements. Teaming Up with Customers What happens when suppliers and customer are disconnected? Consider design work, for example. Whether we speak of goods or services, time- and distance separation in the supplier-customer connection invites trouble. Question: “What’s your Job?” Question: “But isn’t your job to serve the customer?” In grocery stores, where the supplier-relationship is immediate, the operations manager system is hard pressed to maintain a customer focus. The customer is the next process, or where the work goes next. A buyer’s customer is the associate in the department to whom the purchased item goes; a cost accountant’s customer is the manager who uses the accounting operations-where the design will be produced or the service provided. It is also clear that throughout the organization, people not only have customers, they are customers. Let’s turn our attention to what customers want. A Short List of Basic Customer Wants The requirement is a recipient’s or customer’s view of a good or service. A close partnership with the customer’s actual requirements. A close partnership with the customer helps create good specifications, increasing the supplier’s ability to fulfill the customer’s needs. What else do customers want? Customers have six requirements of their providers: High levels of quality. High levels of service. Low costs. OPERATIONS STRATEGY An organizational commitment with wide ranging effects, such as continuing improvement in meeting customer needs, is called a strategy. Strategy itself is necessary because of competition, and successful strategy ensures that company strengths match customer requirements. Integrated Business Strategy To accomplish its aims, the business team must plan strategy in all four-line functions. A comprehensive strategic business plan deals with issues affecting the whole organization: employees, markets, location, line of products and services, customers, capital and financing, profitability, competition, public image and so forth.
Answer - There are usually two issues regarding the revenue. One is about the volume and other one is about the cost. So one person will focus on the volume while the other one will be focusing on cost. There is a part where the problem statement is divided among the people. These sub parts of the problem are managed by a single person or many people depending on the difficulty level.