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Essay / Research Paper Abstract
A 99 page paper. The revenue cycle is the process by which services are provided, charges are made, cash is generated. It includes all the functions from scheduling the patient through final bill resolution. Medical practices, hospitals and other health care facilities lose money because claims are denied. This paper addresses numerous issues involved in the revenue cycle. Some of the many topics discussed include: the Balanced Budget Acts; the cash flow and revenue cycle as it applies to hospitals and physician medical practices; how the HCFA, APC & HIPAA Affect the Revenue Cycle; the definitions of medical necessity and medical benefits according to health plans; the major causes for claim denials; a multitude of steps and approaches to decrease claim denials and improve revenue cycles; liability and appeals; and a special section of improving registration processes to improve the revenue cycle. bibliography lists 26 sources.
Page Count:
99 pages (~225 words per page)
File: MM12_PGrevcyc.rtf
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Unformatted sample text from the term paper:
addresses numerous issues involved in the revenue cycle. Some of the many topics discussed include: the Balanced Budget Acts; the cash flow and revenue cycle as it applies to hospitals
and physician medical practices; how the HCFA, APC & HIPAA Affect the Revenue Cycle; the definitions of medical necessity and medical benefits according to health plans; the major causes for
claim denials; a multitude of steps and approaches to decrease claim denials and improve revenue cycles; liability and appeals; and a special section of improving registration processes to improve the
revenue cycle. bibliography lists 26 sources. PGrevcyc.rtf CHANGING THE REVENUE CYCLE PROCESS IN HOSPITALS , November, 2001 for more information on using
this paper properly! Introduction The healthcare industry has revenues that total $1.1 trillion per year. Hospitals claim approximately one-third of this total. Hospitals also account for one-third of the
Medicare claims each year. Medicare, in the aggregate, spends about $300 billion per year on health care for its members (Neuer, 2000). Health care costs are on the increase
again. Geer reported there is an expected increase in premiums ranging from 10 to 20 percent depending the size of the organization purchasing health insurance. The reasons given for these
dramatic increases are: * Exorbitant Rise of Prescription Drug Costs. * The Aging of the American population, not only are more Americans reaching the Medicare age but the population between
45-64 is swelling. * The failures of many Managed Care Companies in the 1990s have resulted in fewer companies and larger remaining companies. These larger more powerful voices have more
clout with providers to negotiate increased rates. * Increased regulation. * Increased consumer demand. * More common use of expensive technology (Geer 2001). Employers will either pass the costs
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