What is revenue cycle coding?
Coding and Revenue Cycle Management is the process that facilities use to manage the administrative and financial functions associated with patient registration, benefit verification, coding, claims processing, and payment and collection, all integral aspects of revenue generation.
Is coding a major player in the revenue cycle?
Although there are numerous facets to the revenue cycle there are two key players that have a major effect on the revenue cycle. These two departments are the Patient Financial Services (PFS) and Health Information Management’s (HIM) coding department.
Why is coding important to the revenue cycle?
Medical Coding is Vital to Your Revenue Cycle But, accurate coding leads to a clean claim, which results in prompt reimbursement, and that’s why coding impacts your bottom line profoundly. When coding is revered as part of your revenue cycle, efficiency and communication improve, and that’s a sure win.
How does coding affect the revenue cycle?
When the pace of coding slows, revenue cycle performance is impacted. If you have a backlog of charts to code, you risk missing the timely filing deadlines set by payers. They can drive automation with solutions like coding crosswalks for specific payer requirements.
What is meant by RCM?
Revenue cycle management (RCM) is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance. Communicating with health insurance companies is a key component of RCM.
When does revenue cycle management begin and end?
Healthcare revenue cycle management begins when a patient makes his or her appointment to seek medical services and ends when all claims and patient payments have been collected. However, the life of a patient’s account is not as straightforward as it seems.
How is a claim submitted in the revenue cycle?
Claim submission includes sending information to the insurance carrier after the charges have been entered. The revenue cycle team will look at the charges, the CPT code, and the diagnosis code. They will ask whether the diagnosis will support the procedure performed. If two services are provided, those need to be separated and coded correctly.
What do you need to know about revenue codes?
Revenue codes are 3-digit numbers that are used on hospital bills to tell the insurance companies either where the patient was when they received treatment, or what type of item a patient might have received as a patient. A medical claim will not be paid if this is missing from a bill. Revenue codes go along with procedure codes.
What is the Revenue Code for intravenous therapy?
Revenue Code Description 240 All inclusive ancillary, general 260 Intravenous (IV) therapy 261 Intravenous (IV) therapy, infusion pump 262 Intravenous (IV) therapy, pharmacy services 263 . Intravenous (IV) therapeutic drug, supply and delivery 264 Intravenous (IV) therapy, supplies 269 Intravenous (IV) therapy, other 274