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A comprehensive overview of the revenue cycle in the healthcare industry, covering key concepts such as the revenue cycle, the health insurance marketplace, the affordable care act (aca), the medical debt task force, hcahps (hospital consumer assessment of healthcare providers and systems), and the center for medicare and medicaid services (cms). It also discusses the advantages and disadvantages of outsourcing revenue cycle management, the clauses to include when working with collection agencies, and the six performance strategies for revenue cycle management. The document aims to equip healthcare professionals with the knowledge and tools necessary to effectively manage the revenue cycle and improve patient satisfaction.
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What is Revenue Cycle? - CORRECT ANSWERSall steps required to process a patient account from the request for service through closing the account with a 0 balance and purging it from the system Health Insurance Marketplace - CORRECT ANSWERSalso known as Health Insurance Exchange, where individuals and small businesses can compare and purchase qualified health benefit plans ACA - CORRECT ANSWERSAssociation of Credit and Collections Professionals International Medical Debt Task Force - CORRECT ANSWERSbest practice workflow that builds off of HFMAs previous Patient-Friendly Billing work and spans he patient centric revenue cycle. Improves efficiency of the revenue cycle and patient experience HCAHPS - CORRECT ANSWERSHospital Consumer Assessment of Healthcare Providers and Systems, provide a standardized method for evaluating patients' perspective on hospital care How many questions does the HCAHPS survey have? - CORRECT ANSWERS related to clinical care and patient engagement CMS - CORRECT ANSWERSCenter for Medicare and Medicaid Services ADT - CORRECT ANSWERSAdmit, discharge, and transfer system 3 HFMA RC initiatives - CORRECT ANSWERSPatients financial communication best practice Best practices for price transparency Medical account resolution
CRCR conclusion advantages of outsourcing - CORRECT ANSWERScapitalizes on the economies of scale, limits internal staffing requirements, access to qualified staff, vendor absorbs some financial risk based on efficiency factor disadvantages of outsourcing - CORRECT ANSWERSineffective vendor results in increased cost, impact on customer service, legal impact if vendor represents themselves as provider employees, impact on direct control of accounts receivable prior to selecting a vendor providers should - CORRECT ANSWERStalk to vendors employees, sups management, contact current and past vendors, choose a vendor that is successful clauses for collection agencies - CORRECT ANSWERSannual renewal and cancellation clause, understanding that provider has ownership, trail period of 3- months, outlines who will pay the cost of legal action if needed, their job descriptions, the types of reports, a statement on how the vendor is going to protect the confidentiality What are the 6 performance strategies? - CORRECT ANSWERSCulture, process, communications, technology, metrics, people What is the measure of patient satisfaction - CORRECT ANSWERSThe Medicare's Hospital Consumer Assessment of Healthcare Provider and Systems What are the segments of the revenue cycle - CORRECT ANSWERSConsumer experience, patient experience, customer experience