What is a Revenue Cycle?

The healthcare revenue cycle encompasses all the administrative and clinical procedures that are involved in capturing, managing, and collecting patient service revenue. Essentially, it's the entire lifespan of a patient account, from its creation to the point of payment collection.

To maintain a healthy revenue cycle, it's vital to adhere to billing and collection best practices, ensuring that all services rendered are billed and that bills are submitted in accordance with payor requirements. After all, the last thing any healthcare organization wants is to provide services without receiving payment.

The revenue cycle in medical heath care consists of seven key elements:

patient pre-registration
registration
eligibility verification
charge capture
claim submission
payment posting
patient collections

Front Cycle

Patient pre-registration

Prior to an appointment, Medaxcel Optimize manages the patient information to be is gathered as part of the revenue cycle's first crucial stage, patient pre-registration. Pre-registering patients helps to guarantee that their information is correct and current, which can help to decrease claim denials and enhance revenue cycle management.... For more information, please contact.

Registration:

During the registration phase, patients are formally added to the system of the healthcare provider, and their contact and insurance details are recorded. This step is essential because it guarantees that the healthcare practitioner has accurate patient data and is able to submit an appropriate insurance claim on behalf of the patient. For more information,please contact.

Mid Cycle

Eligibility verification

3.This phase entails confirming the patient's suitability for services and the extent of their insurance plan's coverage. This step is crucial as it helps prevent claim denials and delayed payments by confirming that the patient's insurance will pay for the services rendered.... For more information, please contact.

Charge capture

This stage entails recording the services rendered and the fees related to those services. Healthcare professionals enter the services rendered and related costs into the patient's medical record at this stage. The claim is then produced using this data and sent to the patient's insurance provider.... For more information, please contact.

End Cycle

Submission of a claim

Following the documentation of the services, the healthcare professional makes a claim to the patient's insurance provider. This step is essential since it guarantees that the healthcare provider will be paid for the services rendered and helps prevent payment delays... For more information, please contact.

Posting of payments

Following the insurance provider's processing of the claim, the payment is received and deposited to the patient's account. This step is essential because it makes sure the money is credited to the patient's account accurately, preventing payment errors and delays.... For more information, please contact.

Patient collections

The revenue cycle's last stage, patient collections. After insurance payments have been processed, the patient's unpaid balances are collected in this phase. This action is crucial because it guarantees that the healthcare provider is paid for the services rendered and mitigates financial risks and outstanding balances.... For more information, please contact.

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