Why is Revenue Cycle Management Important in Healthcare? Your Guide to Ensuring Profitable Medical Coding Reimbursements

Why is Revenue Cycle Management Important in Healthcare? Your Guide to Ensuring Profitable Medical Coding Reimbursements

The healthcare revenue cycle is a complicated process that connects a series of activities, including everything from patient admission to final payment collection and reporting. Plus, there are behind-the-scenes steps not referenced in the below graphic, such as communication with insurance providers, government payers, and patients. Organizations should rely on a coding reimbursement specialist to monitor and manage this process for them.

coding reimbursement specialist

But why is this process – and the management of said process – so crucial to healthcare organizations?

coding reimbursement specialist

As Healthcare Financial Management Association (HFMA) puts it, “[the] healthcare revenue cycle is the lifeblood of any hospital or health system.” The revenue cycle keeps money coming into the organization so the provider can remain open and deliver care to patients. If any step is missed or done incorrectly, it can have detrimental effects on the overall process and financial reimbursements.

So, healthcare organizations must enact steps to manage the revenue cycle process effectively and efficiently. Thankfully, there are revenue cycle management (RCM) systems that rely on data analytics to help streamline the process. However, these RCM systems aren’t without their challenges.

How To Ensure Accurate Coding For Profitable Reimbursements

One way to guarantee profitable reimbursements is through complete, accurate coding of a patient’s encounter. Establishing a compliance standard for coding significantly reduces the risk of errors, oversight, and, ultimately, denied claims. And, with claims denials avoided, the provider will not lose revenue.

coding accuracy

Healthcare organizations can set and monitor coding standards through regular coding compliance audits. YES HIM Consulting’s team of coding and auditing consultants are experts in identifying outliers and coding errors before they become denied claims.

Additionally, ongoing coding education on the annual ICD-10 and CPT updates, as well as refresher courses on specialty medical topics, make sure that coders will remain compliant with the latest codes and guidelines.

Final Takeaway

Is your organization struggling to stay afloat? Has your revenue cycle been weighed down with too many denied claims that are causing your profits to drift to the red?

YES HIM Consulting is ready to step in as coding reimbursement specialists and turn those losses into profits. Connect with one of our consultants today to discuss your team’s needs and develop an actionable plan for profitable reimbursements.

YES HIM Consulting

coding reimbursement specialist

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