Sample Healthcare Paper on Revenue Cycle Management

Businesses and service providers require revenue to enable them carry out their daily processes efficiently. Service providers, although they need finances for their activities, raising revenue is not one of their primary function in service provision. Revenue management is significant in ensuring that the resources collected are utilized in a proper manner adding value to the organization. In healthcare, raising revenue is not the primary focus for medical care providers. However, providers still need to increase revenue to help them cater for the salaries, buying of equipment and medical supplies, engaging consultants, and purchasing of other support services. Revenue cycle management is vital for the institution in ensuring the smooth provision of services. Inadequate and inappropriate management of the revenue cycle has dire consequences to the individuals concerned and the overall system of healthcare.

Importance of Revenue Cycle Management in Healthcare

Revenue cycle management in healthcare organizations refers to the way the institution handles the process and finances involved from the first encounter with the patient, the services provided up to the billing point. The management system consists of taking into consideration the medical coding claims and the insurance eligibility of the patient (Singh et al, 2016).  The importance of revenue cycle management in the acute care environment assists in providing security of the patient health information and their financial data for use in processing claims. Additionally, the system helps to save costs resulting from denied claims and money lost from billing inefficiencies, thereby enabling timely payment of bills.  The healthcare staff has an easy time to enter patient information in the system for use in billing, thus saves time lost in resubmission or revision of claims (Jadhav, 2018). Moreover, the system links the healthcare provider to the insurance provider and the management, thereby inefficient revenue collection and reporting. Quality of healthcare is improved as nurses have more time to take care of the patient other than process patient bills.

Impact of Revenue Cycle Management

Revenue cycle management has an impact on healthcare as health insurance providers can quickly get information on the services offered, leading to the payment of claims with minimal difficulties. Healthcare quality and processes are improved as the revenue collected from services offered assists in streamlining various departments according to the visions of the organization. The tracking of billing and collection cycles is organized, thereby provide efficient registration of patients, scheduling of an appointment, and effective payment processing procedures (Gilreath et al, 2019).  Additionally, the system helps to bridge the gap between the clinical side and the business side of the healthcare system, reducing confusion on the individual roles.

Consequences of Improper Revenue Cycle Management

The consequences of improper revenue cycle management in healthcare include failure to provide finances for support services leading to the deteriorating quality of care provided.   The insurance providers will have a difficult time to process claims as there are no proper records and coding to determine the reliability of the information provided.  Additionally, there will be higher cases of denial rate, reducing the net revenue of the collected claims (Wright, 2017).  Patient information is highly likely to be stored carelessness leading to reduced services provided and might cause stress to the healthcare staff.  Moreover, increased billing inaccuracies will reduce the process of reimbursements leading to inefficient care provided and poor clinical outcomes.

 

Biblical Annotation towards Revenue Cycle Management

Biblical integration of the revenue cycle management involves viewing the healthcare system as a combination of several parts working in synchronization for one task. Jesus Christ used the parable of the body of Christ to symbolize the different roles of body parts in ensuring the body functions (Beltramini, 2019). In the healthcare system, the involvement of the patient and the nurses in recording the patient’s health information and further facilitate billing processing ensure there is a smooth flow of the healthcare process.

 

References

Beltramini, E. (2019). God and modernity in management studies. A Case of Theological Social Theory. Philosophy of Management18(3), 331-345.

Gilreath, M., Morris, S., & Brill, J. V. (2019). Physician Practice Management and Private Equity: Market Forces Drive Change. Clinical Gastroenterology and Hepatology17(10), 1924-1928.

Jadhav, B. R., & Krishna, D. (2018). A Study of Revenue Cycle Management of the Hospital. International Journal in Management & Social Science6(9), 196-214.

Singh, R., Mindel, V., & Mathiassen, L. (2016, January). IT-Based Revenue Cycle Management: An Action Research into Relational Coordination. In 2016 49th Hawaii International Conference on System Sciences (HICSS) (pp. 3152-3161). IEEE.

Wright, K. (2017). Revenue Cycle and Reimbursement. Health Information Management: Principles and Organization for Health Information Services.