Corporate Compliance

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

Compliance Monitor, January 11, 2005

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.