Paper on Interrelationship between the Revenue Cycle and Reimbursement

A revenue cycle includes all the relevant rules and management procedures that help healthcare organizations gather and capture the revenues generated from offering services to patients. Wright (2017) asserts that reimbursement involves the procedure of repaying the cash incurred in service provision. Therefore, the reimbursement deal has a significant relationship with the revenue cycle since both work together to promote revenue cycle management. The healthcare firms gain revenue from offering treatment services to patients, who may pay in cash or via insurance companies. The department that keeps records in the healthcare system is responsible for capturing the relevant data concerning patients and the health officials’ codes. The data is then sent to the client’s insurance for reimbursement or billed according to the patients’ payment agreements.

The hospital Chargemaster, on the other hand, refers to the list of all the billable items and services to patients or their insurance companies. The documentation and codes are usually translated by capturing the charges and adjusting them to the Chargemaster’s rates. The costs are later used to bill patients and generate the payers’ claims. Hospital Chargemaster is important in the healthcare system’s revenue cycle (Lee & Blanchfield, 2018). If implemented and maintained effectively, the Chargemaster boosts the integrity of a revenue cycle by ensuring accurate payments and that healthcare systems comply with the violations and charging for services. Hospitals should, therefore, seek to embrace the Chargemaster to ensure they boost integrity in their operations.

The revenue cycle and the reimbursement deal have a relationship that boosts the effectiveness of the management of revenue services. The hospital Chargemaster, on the other hand, plays a vital role in promoting the integrity of a healthcare revenue cycle by ensuring the organizations adhere to the guidelines and provide the correct payments and charges for services.

References

Lee, V. S., & Blanchfield, B. B. (2018). Disentangling health care billing: for patients’ physical and financial health. Jama319(7), 661-663.

Wright, K. (2017). Revenue Cycle and Reimbursement. Health Information Management:

Principles and Organization for Health Information Services.