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The Revenue Cycle

QuestionAnswer
The __________ is the administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. Revenue Cycle
Pre-Registration is the first step in the Revenue Cycle. What is Pre-Registration? Collection of information before the patient arrives.
Registration is a step in the Revenue Cycle. What is Registration? Collecting subsequent patient information during registration.
Charge Capture is a step in the Revenue Cycle. What is Charge Capture? Rendering services into billable charges.
Utilization Review is a step in the Revenue Cycle. What is a Utilization Review? When health insurance companies review a request for medical treatment.
Coding is a step in the Revenue Cycle. What is Coding? Properly coding diagnoses and procedures.
Claim Submission is a step in the Revenue Cycle. What is Claim Submission? Submitting claims of billable fees to insurance companies.
Remittance Processing is a step in the Revenue Cycle. What is Remittance Processing? Applying/rejecting payments after they have been received.
Insurance Follow-Up is a step in the Revenue Cycle. What does Insurance Follow-Up mean? Collecting payments from third-party insurers.
Patient Collections is a step in the Revenue Cycle. What is Patient Collections? Determining patient balances and collecting payments.
__________ is a phrase used to refer to the process of paying claims submitted or denying them after comparing claims to benefits or coverage requirements; insurance companies adjudicate claims when they are submitted. Claim or Payment Adjudication
A comprehensive listing of items billable to a hospital patient or patient's health insurance provider. A ____________ is described as "the central mechanism of the Revenue cycle." Charge Description Master (CDM)
Created by: cattomko
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