Corporate Compliance

Tip: Joint effort by HIM and the business office helps manage the revenue cycle

Compliance Monitor, January 11, 2005

Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!

Teaming with health information management (HIM) can help you measure and track your revenue cycle management initiative, says Rose Dunn, RHIA, CPA, FACHE, FHFMA, chief operating officer of First Class Solutions in St. Louis.

Collaborating with your peers in HIM is key. Dunn suggests some items that should be on your dashboard--and on the HIM department's as well--to improve your revenue cycle efforts:

1. Monitoring components of the discharge-to-collection time frame

  • Discharge to code
  • Code to bill
  • Bill to collection (primary payer)
  • Primary payer remittance to bill (secondary payer)

    2. Denial management (identifies issues that adversely impact revenue)

  • Monitoring denial percentage (denials as a percent of all claims issued during the period or denied dollars as a percentage of all dollars billed during period)
  • By revenue department (dollars and number)
  • By revenue code (dollars and number)
  • By payer (dollars and number)
  • By physician--specifically outpatient tests/services (dollars and number)
  • Track and trend denials

    3. Reports/stats

  • Aging report
  • Days in A/R

    4. Coding audit results

  • Accuracy percentage by record type
  • Track and trend

    Editor's note: This tip comes to you courtesy of Patient Financial Services Advisor Weekly, a new publication from HCPro, Inc. For more information, visit HCPro's Healthcare Marketplace. To sign up for this free weekly newsletter, click here.



    • Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!

      Strategies for Health Care Compliance

    • Strategies for Health Care Compliance

      News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...

    • Compliance Monitor

      This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...

    • Medicare Weekly Update

      Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...

    • Medicare Update for Physician Services

      Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...

    Most Popular

    Related Articles