The Revenue Cycle Management Review is an assessment of the client Hospital’s systems that relate or impact its revenue cycle. The purpose of the evaluation is to analyze the efficiency and effectiveness of current systems, review performance, and to recommend changes to enhance performance and increase cash flow.
The Review would include an overview of all of the Patient Financial Services Procedures, a review of current staffing, and an evaluation of admissions, registration, coding, billing, collections and follow up. In addition, BRHS will evaluate posting of payments, write-off procedures, and any problem areas identified by Management. During this process BRHS will work with Patient Financial Services, Health Information Management, and Management Information Systems personnel to determine problem areas, difficult procedures and inaccurate policies.
Areas of review include:
- Review and recommend revisions, as necessary, of Patient Financial Services policies and procedures to optimize performance and accuracy of staff
- Evaluate the operations of Patient Financial Services, Health Information Management, and Management Information Systems personnel to determine if they are following the Hospital’s policies and procedures
- Observe the work habits of the Patient Financial Services staff
- Identify areas of possible lost income due to lost charges, and improper billing
- Evaluate the admission, billing, and follow up procedures. Compare actual operations with printed policies and procedures
- Evaluate the posting of payments and changes in financial class
- Validate discharge-based payor coding for compliance purposes
- Review current charge structure
- Review ER Coding and documentation
Upon completion, a written report will be presented to Administration. The report will detail the findings of the review, make recommendations for improving operations, recommend changes in the current policies and procedures, and make recommendations to improve productivity.