Improving the revenue cycle can be a daunting task due to the scope and complexity of the interdepartmental process Custom Essay

To quote Jonathan Clark at the beginning of his article, “Improving the revenue cycle can be a daunting task due to the scope and complexity of the interdepartmental process.” Of the suggestions offered by the authors, which concept(s)give you the greatest insight into creating an improved Revenue Cycle process in the organization where you work (or one in which you are familiar)? Be sure to identify which article or author you are referencing.
Clark, J., (2008). Strengthening the revenue cycle: a 4-step method for optimizing payment. Healthcare Financial Management, 62 (10), 44.
Hammer, D. C. (2007). The next generation of revenue cyclemanagement. Healthcare Financial Management, 61 (7), 49
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To quote Jonathan Clark at the beginning of his article, “Improving the revenue cycle can be a daunting task due to the scope and complexity of the interdepartmental process.” Of the suggestions offered by the authors, which concept(s) give you the greatest insight into creating an improved Revenue Cycle process in the organization where you work (or one in which you are familiar)? Be sure to identify which article or author you are referencing.

I do not work in the Revenue cycle at my hospital, but I think that we could benefit in particular by the following the recommendations listed under “charge capture” in Jonathan Clark’s article “Strengthening the Revenue Cycle: a 4-step Method for Optimizing Payment” which include identification of high dollar procedures, implants, supplies, and drugs and listing these in descending order and then checking the items on this list to see if they are being charted correctly, then charged, billed, and reimbursed accurately. In the OR, we have pyxis machines which are basically inventory control systems. I think many hospitals use them for pharmacy drugs, but at my hospital we use them for supplies and implants in the OR as well. The pyxis causes a lot of errors in charting in the OR, mainly because there is so much room for error with this system (it is not user-friendly) and the nurses are busy taking care of the patients first and focused on turning over the rooms quickly between cases second. They are not as concerned with charge capture. As a result, pyxis transactions (takes and credits to the patient’s chart) do not get validated consistently after a case is done. Even though I am not part of the Revenue Cycle, I get brought in to look at the pyxis errors that accumulate and I have to figure out if we charged for the correct items and credited for the items that were returned (not used). I then send the information to the Fiscal Techs (who are part of the revenue cycle) which process the additional charges or credits. There are times that I cannot figure out what the nurse meant to do so I do have to consult with the circulator in the case to confirm. The problem is really our processes in the OR and I have suggested solutions to fix the processes. It remains to be seen if those proposed solutions will be implemented. If the steps mentioned above were implemented though, it would help illuminate for higher ups the fact that we are missing high dollar charges and also charging for things that should not be charged for. (We do correct the charges if we find that we should have credited a patient, but it will likely be delayed.)

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