Cure All Hospital has received a number of payer denials for services billed with incorrect CPT codes...

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General Management

Cure All Hospital hasreceived a number of payer denials for services billed withincorrect CPT codes and revenue codes. After investigating, Janediscovered that several departments were submitting their chargesusing electronic source systems or paper charge tickets that hadnot been updated to match the billing system’s charge master.

Discuss what Janeshould do to correct this problem and measures that should be putin place to ensure that the CDM is correct and that electronicsource systems and paper charge tickets areupdated.
In addition to theabove real world case, answer the questions below.
1. Identifythe phases of the revenue management life cycle and the activitiesincluded in each phase.

2. Discuss theinterrelationships that exist among the revenue cycle activities inthe different phases, and the impact they can have for theorganization’s financial health.
3.Identify tools and techniques used to improve healthcarefinance and discuss the role technology plays in successful revenuecycle management

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1 Revenue management life cycle Goal of healthcare revenue management life cycle is to help the organisations to get paid the full amount for services as soon as possible Steps in Revenue management life cycle 1RCM software or Outsourcing prossessing Depending on the medical organisation size u can decide on processing methodIf the organisation is small and have good IT team members they can go for RCM software on their own servers IF not they can outsource i t to third party experts 2Patient PreAuthorization Process of obtaining approval from See Answer

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