1. Patient Financial Service Delivery (Health Information Management)
Revenue Cycle Definition
Other Non-Acute
Physician
Patient Access
Patient Financial Service Delivery
(Health Information Management)
Revenue Realization
Acute
Initial and
Extended
Authorizations
Release of
Information
Point-of-Service Collections
Claim Editing and Submission
Patient
Follow-up
Functions
Core
Denials Management
and Appeals
Coding, Quality, Clinical Documentation
Registration and Admissions
Insurance Verification
Correspondence
Payment
Variance
Resolution
Bill Hold
Resolution
Exception
Based
Follow-up
Financial
Counseling
Transaction Processing
Pre-Registration
Core Functions Spanning the Revenue Cycle
Charge Description Master Maintenance / Pricing Coordination, Customer Service, Managed Care Coordination and Vendor Performance Management
Adjacent Functions Spanning the Revenue Cycle
Managed Care Contracting, Pricing and Physician Credentialing
Referral
Adjacent
Functions
Scheduling
Charging
Utilization Review
Abstracting
Check-Out
Assembly
and
Analysis
Case Management/ Discharge Planning
Physician Record
Completion
Transcription
Supporting Functions
Information Technology Services, Human Resources, Supply Chain Management, Corporate Compliance and Finance