The revenue cycle is a “recurring set of business activities and related
information processing operations associated with providing goods
and services to customers and collecting cash in payment for those
sales” (Romney, 2020, p.428). The revenue cycle is important to all
businesses even if the components to the cycle is not the same.
The article that I read is called Revenue Cycle Management
Compliance—How Policies and Procedures Provide a Solid and
Effective Foundation. In this article the author talks about revenue
cycle management and how important it is to the healthcare industry.
It is used to “manage the administrative and clinical functions
associated with claims processing, payment, and revenue generation”
(Thomas, 2022, p. 35). It is a complex system of processes that
consist of “identifying, managing, and collecting patient service
revenue, beginning when a patient makes an appointment for medical
services and concluding when all claims and patient payments
associated with that appointment have been collected” (Thomas,
2022, p. 35). These processes include patient scheduling, benefit and
eligibility verification, patient encounter, medical documentation,
medical coding, charge capture, claims generation and submission,
cash and payment posting, secondary billing, patient billing, accounts
receivable, denials management, auditing, reporting, and
benchmarking (Thomas, 2022, p. 35). All RCM steps are well defined
and all RCM staff are educated on the steps and associated policies
and procedures. There are certain healthcare organizations that will
need “additional policies to address the RCM function” (Thomas,
2022, p. 36) while some organizations “only need a limited set”
(Thomas, 2022, p. 36).
Reference
Romney, M. B., Steinbart, P. J., Summers, S. L., & Wood, D. A. (2020).
Accounting Information Systems (15th ed.). Pearson Education (US).
https://mbsdirect.vitalsource.com/books/9780135573082
Thomas, S. (2022). Journal of Health Care Compliance. Revenue
Cycle Management Compliance—How Policies and Procedures
Provide a Solid and Effective Foundation. (PP. 35-37). Retrieved
from: https://eds-p-ebscohost-
com.ezproxy.snhu.edu/eds/pdfviewer/pdfviewer?vid=4&sid=b3b365
0a-76ab-4a25-b4ed-4d58879aff84%40redis
