Week Eleven: Revenue Cycle Implementation Assess the needs of an organization us

Question

Week Eleven: Revenue Cycle Implementation

Assess the needs of an organization using problem-solving and critical thinking techniques and develop a process for managing the revenue cycle in a healthcare facility.

Anywhere Hospital's CFO for the past 20 years, Jim Smith, just retired. He worked for the hospital for 40 years and was greatly respected by his staff. The hospital governing board has hired a new CFO, Todd White.

Jim Smith utilized the silo approach to revenue cycle management during his tenure. He relied on his key management personnel to contact upper management of other departments in the hospital to discuss issues and to resolve problems and vice versa.

Todd White, however, had implemented an integrated revenue cycle team at his former hospital three years ago and strongly believed in the power of teamwork. His previous team had gained numerous efficiencies and improved accounts receivable by millions. So when Todd started at Anywhere Hospital he planned on implementing a similar revenue cycle team.

As with any change, Todd was met with much resistance. But after speaking with many of his managers in patient accounts and finance he realized that the employees did not know how to effectively work in teams. And why should they the previous CFO had not asked them to do so in several years.

5. Explain goals and objectives a revenue cycle team might consider to implement processes for revenue cycle management and reporting.

6.Develop a plan to review the charge master annually.

Explanation / Answer

Explain goals and objectives a revenue cycle team might consider to implement processes for revenue cycle management and reporting.

The general goals along with more specific objectives are listed below:

Establishing organizational structures and process workflows for Charge Description Master [CDM] management:

For a CDM to work continuously and smoothly appropriate hierarchy and work patterns should be established and, therefore, the following objectives are defined:

Provide education and training to clinical managers in the CDM process:

Adequate knowledge about CDM process among all the staff and managers are crucial for compliance with the company’s policy. The objectives for this are:

Enhance documentation of CDM-related procedures:

It is crucial to document all the medical procedures in hospitals so that it can be properly coded. Moreover, all the details pertaining to CDM must also be documented. For this to occur the following objectives are set:

These are some of the goals and objectives of revenue cycle management.

Develop a plan to review the charge master annually.

Charge master or Charge Description Master refers to a list of all the billable items of a patient to either a hospital or the patient’s insurance company. It plays a significant role in revenue cycle management.

Planning:

Effective CDM begins with coding the medical processes correctly and goes beyond t. adequate staff education is crucial to its success.

In any business issues or problems, there should be a cycle for initiating and maintaining improvement. There are four steps in making improvements in a business. Plan, Do, Check, Act or PDCA.

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